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"Is It Removed During Dialysis?"-Cognitive Dysfunction in Advanced Kidney Failure-A Review Article
Kirsty Crowe1, Terence J Quinn2, Patrick B Mark1,2
1Glasgow Renal and Transplant Unit, Queen Elizabeth University Hospital, Glasgow, United Kingdom.
Frontiers in Neurology
|December 20, 2021
Summary
Cognitive impairment is common in kidney disease patients, especially those on kidney replacement therapy (KRT). Understanding and assessing this complication is vital for improving patient quality of life and outcomes.
Area of Science:
- Nephrology
- Neurology
- Geriatrics
Background:
- Kidney disease is strongly linked to cognitive impairment, which worsens with declining kidney function.
- Cognitive impairment is significantly more prevalent in patients requiring kidney replacement therapy (KRT), such as dialysis or transplantation.
- Historical accounts and modern research highlight the long-recognized cognitive effects of kidney failure and its treatments.
Purpose of the Study:
- To review the history, mechanisms, effects, and implications of cognitive impairment in kidney failure.
- To provide a practical approach to clinical assessment of cognitive function in renal patients.
- To discuss evidence-supported treatments and future directions for managing cognitive impairment in kidney disease.
Main Methods:
- Literature review encompassing historical data and current research on cognitive impairment in kidney failure.
- Analysis of proposed mechanisms including vascular aging, multi-morbidity, inflammation, and uremic toxins.
- Discussion of clinical assessment strategies and treatment interventions.
Main Results:
- Cognitive impairment is a frequent extra-renal complication of kidney failure, impacting quality of life, hospitalization, and mortality.
- Multiple factors contribute, including uremic toxins, chronic inflammation, vascular aging, and dialysis effects.
- Limited but promising treatments exist, including exercise, dialysis adjustments, and transplantation.
Conclusions:
- Cognitive impairment is a critical, often under-recognized, complication of kidney failure with significant patient impact.
- Pragmatic clinical assessment is necessary to identify and manage cognitive issues in renal care.
- Further research and interventions targeting cognitive function are pivotal for improving patient outcomes in kidney disease.
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