Prevalence and risk factors of cognitive dysfunction in chronic hemodialysis patients

Abstract

There is a high prevalence of cognitive dysfunction among hemodialysis patients and many causative factors have been evoked. Effective identification of this trouble allows adequate psychological interventions to improve the quality of life of these patients.

Cognitive Impairment and Its Associated Factors in Patients Undergoing Hemodialysis: A Cross Sectional Study

“…This and similar studies cited have unanimously concluded that cognitive impairment is worryingly common in patients with renal failure. The prevalence of cognitive impairment was reported as 18.8% in Japanese patients undergoing hemodialysis (12) and as 25% in Moroccan patients by Wechsler memory test (16). Different studies have thus reported different prevalence rates for cognitive impairment in hemodialysis patients; this disparity may be attributed to the different diagnostic methods used, the different measures used for assessing cognitive impairment and the different sample populations examined and methods of sampling used.…”

“…For example, Odagiri et al (12) argued that hemodialysis treatment is an independent risk factor for cognitive impairment in patients with renal failure. Fadili et al (16) also found that lower levels of education and anemia are risk factors for the incidence of cognitive impairment in patients undergoing hemodialysis. In a study by Eslami-Amirabadi et al (15), cognitive impairment was found to be associated with age, lower levels of education and diabetes mellitus, depression and positive qualitative CRP.…”

“…Those who receive a score of ≥26 are considered normal (23), and a score is added to the total score obtained for those with less than 12 years of education (22,23). Previous studies conducted on this subject in Iran or in other countries have often used the MMSE to assess cognitive impairment (12,15,16); however, since the MMSE is not highly capable of making an early diagnosis of mild cognitive impairment compared to the MoCA (19,24) and also has a low specificity of 53% (22), the researchers set out to use the newer MoCA, which has been developed mainly to resolve the defects in the MMSE and which has a higher sensitivity (19).…”

“…Different statistics have been reported for the prevalence of cognitive impairment in patients with ESRD following hemodialysis, ranging from 20% to 47% (11)(12)(13)(14)(15)(16). Many factors have been found to contribute to cognitive impairment in patients with ESRD undergoing hemodialysis, including salt retention, hypotension, hemodynamic instability during dialysis, anemia and different hemodialysis protocols.…”

“…Regional statistics are limited on this disease, especially in the case of patients undergoing dialysis in northern Iran (15). Given the recommendations of previous studies to further examine cognitive impairment in patients with ESRD undergoing hemodialysis (16), and also given the need to identify the underlying factors causing this disorder, the present study was designed. Its objective was to examine the prevalence of cognitive impairment and its associated factors in hemodialysis patients in the north of Iran.…”