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2020, Number 2

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Rev Nefrol Dial Traspl 2020; 40 (2)

Cognitive impairment without dementia in end-stage chronic renal disease. data from an argentinian center

Castellano M, Bernarte M, Castellano CA, Favaro ML, Mateo VE

Language: Spanish
References: 16
Page: 119-128
PDF size: 274.15 Kb.


ABSTRACT

Objectives: To assess cognitive performance in a hemodialysis population. To know relationship between IRCT and the presence of cognitive impairment, as well as the influence of hemodialysis treatment. Identify other variables that could influence cognitive performance. Methods: quasi-experimental study design, cross section. 25 adult subjects with ESRD on hemodialysis were included. Control group consisted of 4 healthy subjects. Medical histories, information on dialysis and laboratory tests were recorded. Individual interviews were conducted using the Neuropsi test being performed by a single operator. Results: 36% of patients had alterations in attention and executive functions and 24% had impaired memory. Patients with abnormal results in attention and executive functions had older and proportion of women although not statistically significant, plus higher percentage of hypertension, ischemic heart disease and smoking. This group had lower levels of hematocrit (32.11 ± 4.96 vs 35.69 ± 1.40, p = 0.01) and hemoglobin (10.67 ± 1.55 vs 11.98 ± 0.51, P = ‹0.01) and a tendency to total cholesterol and lower triglycerides. Patients with abnormal results in memory had a greater number of episodes of hypotension (5.83 ± 2.64 vs 2.63 ± 3.29; p = 0.04), a higher proportion of patients with hypertension (66.7% vs 26.3%; p = 0.07) and more levels low hemoglobin (10.72 ± 1.75 vs 11.76 ± 0.84, P = 0.05); without significant differences in levels of calcium and phosphorus metabolism, PTH, albumin, glucose or lipids. Conclusions: HD patients are a high-risk population and higher prevalence of cognitive disorders. Both comorbid causes associated with chronic vascular disease and inflammation disorders and malnutrition are factors that are associated with worse outcomes.


REFERENCES

  1. Fraser CL, Arieff AI. Nervous system complicationsin uremia. Ann Intern Med. 1988;109(2):143-53.doi:10.7326/0003-4819-109-2-143.

  2. Fukunishi I, Kitaoka T, Shirai T, Kino K, Kanematsu E,Sato Y. Psychiatric disorders among patients undergoinghemodialysis therapy. Nephron. 2002;91(2):344-7.doi:10.1159/000058418.

  3. Kimmel PL, Thamer M, Richard CM, Ray NF.Psychiatric illness in patients with end-stage renaldisease. Am J Med. 1998;105(3):214-21. doi:10.1016/s0002-9343(98)00245-9.

  4. Sehgal AR, Grey SF, DeOreo PB, Whitehouse PJ.Prevalence, recognition, and implications of mentalimpairment among hemodialysis patients. Am JKidney Dis. 1997;30(1):41-9. doi:10.1016/s0272-6386(97)90563-1.

  5. Kurella M, Chertow GM, Fried LF, Cummings SR,Harris T, Simonsick E, et al. Chronic kidney diseaseand cognitive impairment in the elderly: the health,aging, and body composition study. J Am Soc Nephrol.2005;16(7):2127-33. doi:10.1681/ASN.2005010005.

  6. Gilli P, De Bastiani P. Cognitive function and regulardialysis treatment. Clin Nephrol. 1983;19(4):188-92.

  7. Kutlay S, Nergizoglu G, Duman N, Atli T, KevenK, Ertürk S, et al. Recognition of neurocognitivedysfunction in chronic hemodialysis patients. Ren Fail.2001;23(6):781-7. doi:10.1081/jdi-100108189.

  8. Murray AM, Tupper DE, Knopman DS, Gilbertson DT,Pederson SL, Li S, et al. Cognitive impairment in hemodialysispatients is common. Neurology. 2006;67(2):216-23. doi:10.1212/01.wnl.0000225182.15532.40.

  9. Wolcott DL, Wellisch DK, Marsh JT, SchaefferJ, Landsverk J, Nissenson AR. Relationship ofdialysis modality and other factors to cognitivefunction in chronic dialysis patients. Am J KidneyDis. 1988;12(4):275-84. doi:10.1016/s0272-6386(88)80220-8.

  10. Griva K, Newman SP, Harrison MJ, Hankins M,Davenport A, Hansraj S, et al. Acute neuropsychologicalchanges in hemodialysis and peritoneal dialysis patients.Health Psychol. 2003;22(6):570-8. doi:10.1037/0278-6133.22.6.570.

  11. Sánchez-Román S, Ostrosky-Solís F, Morales-Buenrostro LE, Nogués-Vizcaíno MG, Alberú J,McClintock SM. Neurocognitive profile of an adultsample with chronic kidney disease. J Int NeuropsycholSoc. 2011;17(1):80-90. doi:10.1017/S1355617710001219.

  12. Ostrosky-Solís F, Gómez ME, Matute E, Roselli M, Ardila A. Pineda D. Neuropsi: atención y memoria 6a 85 años. Manual, instructivo y puntuaciones totales.México D.F: 2003.

  13. Marinovich S, Lavorato C, Celia E, Bisignano L,Soratti M, Hansen-Krogh D, et al. Registro Argentinode Diálisis Crónica 2008. Informe 2010. Nefrol Argent.2011;9(Supl. 1, parte 2):71-127.

  14. Graham JE, Rockwood K, Beattie BL, Eastwood R,Gauthier S, Tuokko H, et al. Prevalence and severityof cognitive impairment with and without dementia inan elderly population. Lancet. 1997;349(9068):1793-6.doi:10.1016/S0140-6736(97)01007-6.

  15. Di Carlo A, Baldereschi M, Amaducci L, Maggi S,Grigoletto F, Scarlato G, et al. Cognitive impairmentwithout dementia in older people: prevalence,vascular risk factors, impact on disability. The ItalianLongitudinal Study on Aging. J Am Geriatr Soc.2000;48(7):775-82. doi:10.1111/j.1532-5415.2000.tb04752.x.

  16. Plassman BL, Langa KM, Fisher GG, Heeringa SG,Weir DR, Ofstedal MB, et al. Prevalence of cognitiveimpairment without dementia in the United States. AnnIntern Med. 2008;148(6):427-34. doi:10.7326/0003-4819-148-6-200803180-00005.




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