Prevalence of Cognitive Impairment among Peritoneal Dialysis Patients, Impact on Peritonitis and Role of Assisted Dialysis

Shea, Yat‐Fung; Lam, Man Fai; Lee, Mi Suen Connie; Mok, Ming Yee Maggie; Lui, Sing-Leung; Yip, Terence; Lo, Wai Kei; Chu, Leung Wing; Chan, Tak Mao

doi:10.3747/pdi.2014.00247

Cited by 29 publications

(41 citation statements)

References 19 publications

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“…12 Additionally, a higher number of comorbidity was negatively associated with nonadherence fluid intake among Chinese hemodialysis patients. 39 Similar to our study, some studies failed to detect any impact of gender, education, or employment on nonadherence. 16,38 This study has several strengths, including it being the first local study to estimate the prevalence and the associations of psychosocial predictors with nonadherence, using multiple validated psychosocial outcomes, in a multicenter experience, with adjustments for relevant demographic and clinical characteristics.…”

Section: Resultssupporting

confidence: 57%

“…37,38 However, our rate of cognitive impairment was higher than reported by other studies. 6,39 Cognitive impairment in our patients was strongly associated with older age (data not shown). Similarly, aging in dialysis patients and the presence of cerebrovascular diseases were shown to play a major role in the pathophysiology of cognitive impairment.…”

Section: Resultsmentioning

confidence: 99%

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<div>Psychosocial predictors of nonadherence to medical management among patients on maintenance dialysis</div>

Alosaimi¹,

Asiri²,

Alsuwayt³

et al. 2016

IJNRD

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Section: Resultssupporting

confidence: 57%

Section: Resultsmentioning

confidence: 99%

<div>Psychosocial predictors of nonadherence to medical management among patients on maintenance dialysis</div>

Alosaimi¹,

Asiri²,

Alsuwayt³

et al. 2016

IJNRD

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“…Through more specific screening in Hong‐Kong patients commencing PD, the administration of the Montreal Cognitive Assessment (MOCA) tool during PD training identified NCI in 29%, with a 4‐fold increase among those patients over 65 years. In addition to age, terminating education below secondary level and a history of hypertension or peripheral vascular disease was associated with the detection of NCI . Cross‐sectional analysis comparing a formal neuropsychological test battery in English‐speaking patients established on PD, HD or healthy volunteers found an odds ratio for NCI compared to control of 2.58 and 3.1 for PD and HD, respectively, against a control NCI rate significantly higher than commonly reported .…”

Section: The Impact Of Dialysis Modalitymentioning

confidence: 90%

“…Data from home‐based dialysis therapies, where clinically obvious NCI is typically a barrier to entry and concerns regarding independence, technique and patient survival are magnified, is much more limited. A single 1‐year prospective cohort study of 114 PD patients found those with confirmed NCI report significantly higher requirements for assistance with dialytic and day‐to‐day care, while demonstrating no difference in terms of PD‐associated peritonitis rates . The risk of developing NCI once established on a home‐based therapy, or the hypothesis that this dialysis choice might be in some way protective, is challenged by selection biases inherent to home‐dialysis and has not been explored.…”

Section: Implications and Perspectivesmentioning

confidence: 99%

Known unknowns: Examining the burden of neurocognitive impairment in the end‐stage renal failure population

et al. 2018

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The burden of neurocognitive impairment (NCI) in patients receiving maintenance dialysis represents a spectrum of deficits across multiple cognitive domains which are associated with hospitalisation, reduced quality-of-life, mortality and forced decision-making around dialysis withdrawal. Point prevalence data suggests that dialysis patients manifest NCI at rates 3-5 fold higher than the general population with executive function the most This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.1111/nep.13223This article is protected by copyright. All rights reserved.Accepted Article commonly affected cognitive domain. The unique physiology of the renal failure state and maintenance dialysis appears to drive an excess of vascular dementia subtype compared to the general population where classical Alzheimer's disease predominates. Despite the absence of evidence based cost-effective therapies for NCI, detecting it in this population creates opportunity to proactively personalise care through education, supported decision making and targeted communication strategies to cover specific areas of deficit and help define goals of care. This review discusses NCI in the dialysis setting, including developments in the definition of neurocognitive impairment, dialysis-specific epidemiology across modalities, screening strategies and opportunities for dialysis providers in this space.

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“…Another solution is to try a multisensory approach, using photographs of the bagexchange procedure or the provision of simple, step-by-step instructions on audiotape (21). A study on the prevalence of cognitive impairment (CI) in PD patients using Montreal Cognitive Assessment found that CI was not a significant independent risk factor for PD-related peritonitis among self-care PD patients with adequate training (22).…”

Section: Learning Plans and Evaluationmentioning

confidence: 99%

A Syllabus for Teaching Peritoneal Dialysis to Patients and Caregivers

et al. 2016

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ISPD GUIDELINES/RECOMMENDATIONSBeing aware of controversies and lack of evidence in peritoneal dialysis (PD) training, the Nursing Liaison Committee of the International Society for Peritoneal Dialysis (ISPD) has undertaken a review of PD training programs around the world in order to develop a syllabus for PD training. This syllabus has been developed to help PD nurses train patients and caregivers based on a consensus of training program reviews, utilizing current theories and principles of adult education. It is designed as a 5-day program of about 3 hours per day, but both duration and content may be adjusted based on the learner. After completion of our proposed PD training syllabus, the PD nurse will have provided education to a patient and/or caregiver such that the patient/caregiver has the required knowledge, skills and abilities to perform PD at home safely and effectively. The course may also be modified to move some topics to additional training times in the early weeks after the initial sessions. Extra time may be needed to introduce other concepts, such as the renal diet or healthy lifestyle, or to arrange meetings with other healthcare professionals. The syllabus includes a checklist for PD patient assessment and another for PD training. Further research will be needed to evaluate the effect of training using this syllabus, based on patient and nurse satisfaction as well as on infection rates and longevity of PD as a treatment. . Based on the principles of adult learning, these guidelines established a broad description of a course and a set of proposals to aid the teacher/nurse (hereafter called the PD nurse). The committee currently believes that, while the recommendations are still relevant and agree with current teaching practices in PD clinics, there is a need for a more comprehensive course to guide PD nurses.The 2006 Guidelines tried to answer some questions that arise when talking about PD training: Who should be the trainer? Who is the learner? What should be taught? Where should the training occur? What should be the duration of training? How should the patient be taught? However, many of these questions remain unanswered. A search in PubMed using the words "training," "patient education," "peritoneal dialysis," and "peritonitis" found only 17 articles published in the last 5 years, and most of these were about infection prevention. Only 4 were published in the last 12 months. Of these 1 article was a narrative review of the literature of educational interventions in PD which concluded that the topic remained an under-studied aspect of PD (2); another looked at the impact of training hours on infection and suggested a minimum of 15 hours training, to be done before catheter implantation or more than 10 days after (3), and the remaining 2 looked at preventing PD infections (4,5). One further observational study, by Firanek et al., analyzing best practices for nurse-led PD training programs for patients on automated peritoneal dialysis (APD) in the United States, stated that best practices...

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Prevalence of Cognitive Impairment among Peritoneal Dialysis Patients, Impact on Peritonitis and Role of Assisted Dialysis

Abstract: Cognitive impairment is common among local PD patients. Even with CI, peritonitis rate in self-care PD with adequate training is similar to CI patients on assisted PD.

Cited by 29 publications

References 19 publications

<div>Psychosocial predictors of nonadherence to medical management among patients on maintenance dialysis</div>

<div>Psychosocial predictors of nonadherence to medical management among patients on maintenance dialysis</div>

Known unknowns: Examining the burden of neurocognitive impairment in the end‐stage renal failure population

A Syllabus for Teaching Peritoneal Dialysis to Patients and Caregivers

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