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Changes in Cognitive Function After Kidney Transplantation: A Longitudinal Cohort Study.

Aditi Gupta1, Jonathan D Mahnken2, Joshua Bernal3

  • 1Division of Nephrology and Hypertension, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kansas; Department of Neurology, University of Kansas Medical Center, Kansas City, Kansas; University of Kansas Alzheimer's Disease Center, University of Kansas Medical Center, Kansas City, Kansas; Frontiers Clinical and Translational Science Institute, University of Kansas Medical Center, Kansas City, Kansas.

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
|February 29, 2024
PubMed
Summary
This summary is machine-generated.

Kidney transplantation (KT) significantly improves cognitive function, particularly episodic memory, which normalizes post-procedure. Other cognitive domains show partial recovery, indicating that kidney disease-related cognitive impairment is largely reversible.

Keywords:
Kidney transplant, Cognitive impairment, ESKD

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Area of Science:

  • Nephrology
  • Neuropsychology
  • Transplantation Medicine

Background:

  • Kidney disease is known to impair cognitive function across various domains.
  • The impact of kidney transplantation (KT) on cognitive domains is not fully understood.
  • Understanding cognitive changes post-KT is crucial for patient care and quality of life.

Purpose of the Study:

  • To assess the effect of kidney transplantation (KT) on different cognitive domains.
  • To determine if cognitive improvements after KT are uniform across all cognitive functions.
  • To evaluate the reversibility of cognitive impairment associated with kidney disease.

Main Methods:

  • A prospective cohort study involving patients waitlisted for KT at an academic center.
  • Cognitive function was measured using standard neuropsychological tests before KT, and at 3 months and 1 year post-KT.
  • Linear mixed model analysis was used to evaluate changes in cognitive scores, adjusted for demographic factors.

Main Results:

  • Episodic and verbal declarative memory (Logical Memory I and II) significantly improved post-KT, normalizing to levels comparable to normative data.
  • Semantic memory, verbal fluency (Category Fluency), and psychomotor speed/visuospatial function (DSST) also showed significant improvement post-KT, though DSST scores remained below normative values.
  • Global cognition (MMSE), working memory/attention (Digit Span), and executive function (TMT A and B) did not show significant changes after KT.

Conclusions:

  • Kidney transplantation leads to normalization of episodic and verbal declarative memory.
  • Significant, yet partial, improvements are observed in semantic memory, verbal fluency, and psychomotor speed/visuospatial function post-KT.
  • Cognitive impairment associated with kidney disease is at least partly reversible following kidney transplantation.