Pretransplant Cognitive Function and Kidney Transplant Outcomes: A Prospective Cohort Study

Area of Science:

• Nephrology
• Neuropsychology
• Transplant Surgery

Background:

• Cognitive impairment is prevalent in patients awaiting kidney transplantation (KT).
• The relationship between pretransplant cognitive status and posttransplant outcomes remains unclear.

Purpose of the Study:

• To investigate the association between pretransplant cognitive function and key posttransplant outcomes in kidney transplant recipients.
• To determine if cognitive assessment using the Montreal Cognitive Assessment (MoCA) can predict graft function, survival, and other clinical endpoints.

Main Methods:

• Prospective cohort study involving 501 participants evaluated during pretransplant clinic visits.
• Cognitive function assessed using the Montreal Cognitive Assessment (MoCA) test.
• Statistical analyses included linear mixed effects models, Poisson regression, Cox proportional hazard models, and logistic regression.

Main Results:

• Lower pretransplant MoCA scores did not adversely affect allograft function or secondary outcomes.
• Higher MoCA scores showed a small, clinically insignificant association with a greater decline in graft function.
• Factors like older age, deceased donor KT, longer dialysis duration, and diabetes mellitus history were associated with specific outcomes.

Conclusions:

• Pretransplant cognitive function, as measured by MoCA scores, was not significantly associated with allograft function or key posttransplant outcomes in kidney transplant recipients.
• Cognitive assessment may not be a primary predictor of short-term and long-term success after kidney transplantation.