Impaired frontal executive function and predialytic chronic kidney disease

Area of Science:

• Nephrology
• Neuropsychology
• Cognitive Science

Background:

• Chronic kidney disease (CKD) affects cognitive function.
• Frontal lobe dysfunction is a potential consequence of CKD.
• Previous research has not fully elucidated frontal dysfunction in CKD patients without comorbidities like stroke or depression.

Purpose of the Study:

• To investigate frontal dysfunction in individuals with CKD.
• To assess the relationship between CKD severity and specific cognitive deficits.
• To exclude the influence of stroke and depressive disorders on observed cognitive changes.

Main Methods:

• Cross-sectional, community-based study.
• 529 community-dwelling participants categorized by estimated glomerular filtration rate (eGFR) into normal, mild CKD, and moderate to severe CKD groups.
• Cognitive function assessed using neuropsychological tests including the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease Neuropsychological Assessment Battery, lexical fluency, digit span test, and Wisconsin Card Sorting Test.

Main Results:

• Participants with moderate to severe CKD exhibited significantly higher rates of perseverative responses and errors compared to those with mild CKD and normal kidney function.
• Mean perseverative responses were 28.6 ± 16.9 in moderate to severe CKD vs. 19.0 ± 11.4 (mild CKD) and 17.1 ± 10.6 (normal).
• Odds ratios for moderate to severe CKD were 4.82 for perseverative responses and 5.01 for perseverative errors, indicating a strong association.

Conclusions:

• Frontal dysfunction, specifically perseverative errors and responses, is significantly associated with moderate to severe CKD.
• These findings highlight a distinct cognitive impact of advanced CKD.
• Cognitive screening may be beneficial for patients with moderate to severe CKD.