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Cognitive impairment in peritoneal dialysis patients
Paramjit Kalirao1, Sarah Pederson, Robert N Foley
1Department of Medicine, Hennepin County Medical Center, and University of Minnesota, Minneapolis, MN 55404, USA.
Summary
Two-thirds of peritoneal dialysis patients experience significant cognitive impairment, similar to hemodialysis patients. Cognitive assessment is recommended before and during dialysis therapy to aid self-administration and medication adherence.
Area of Science:
- Nephrology
- Neuropsychology
- Public Health
Background:
- Cognitive impairment is highly prevalent in hemodialysis (HD) patients.
- This study investigates cognitive function in peritoneal dialysis (PD) patients compared to HD patients and controls without chronic kidney disease (CKD).
Purpose of the Study:
- To determine the prevalence and characteristics of cognitive impairment in PD patients.
- To compare cognitive impairment rates between PD, HD, and non-CKD populations.
Main Methods:
- A cross-sectional study comparing 51 PD patients, 338 HD patients, and 101 non-CKD controls.
- Neuropsychological testing assessed memory, executive function, and language over 45 minutes.
- Cognitive impairment was classified using a validated algorithm.
Main Results:
- Two-thirds of PD patients exhibited moderate to severe cognitive impairment.
- Peritoneal dialysis was associated with a 2.5-fold increased risk of moderate to severe global cognitive impairment compared to non-CKD controls.
- Non-white race and low education were linked to cognitive impairment in PD patients.
Conclusions:
- Peritoneal dialysis patients have a high burden of cognitive impairment, comparable to hemodialysis patients.
- Cognitive impairment in PD patients can impact dialysis self-management and medication adherence.
- Routine cognitive assessment is advised for PD patients initiating or undergoing dialysis therapy.
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