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[Neurocognitive Performance in Patients with End-Stage Chronic Kidney Disease: Differences Between Conservative

Luna Sánchez1, Bárbara Lanis2, Nicolás Meza3

  • 1Escuela de Medicina, Universidad de Valparaíso, Valparaíso, Chile.

Revista Medica De Chile
|January 24, 2025
PubMed

Insights

Patients undergoing hemodialysis (HD) show impaired executive functions compared to those on conservative management for chronic kidney disease (CKD). This cognitive decline, particularly in verbal inhibitory control, is evident even with normal cognitive screening results.

Area of Science:

  • Nephrology
  • Neuropsychology
  • Cognitive Science

Background:

  • Cognitive performance in end-stage chronic kidney disease (CKD) patients on hemodialysis (HD) lacks consensus.
  • Understanding cognitive evolution in CKD patients is crucial for comprehensive care.

Purpose of the Study:

  • To analyze and compare cognitive performance in patients with end-stage CKD undergoing conservative management versus hemodialysis.
  • To identify specific cognitive domains affected by hemodialysis treatment.

Main Methods:

  • A cross-sectional study design was employed.
  • Cognitive performance was assessed using the INECO Frontal Screening (IFS) instrument.
  • 12 patients were analyzed, with 6 in the conservative management group and 6 in the hemodialysis group.

Main Results:

  • Hemodialysis patients scored significantly lower on the total IFS score (14.4±6.29) compared to the conservative management group (21.5±3.96).
  • A significant difference was observed in verbal inhibitory control, with lower scores in the hemodialysis group (1.83±1.17) versus the conservative group (4±0.89).
  • No significant associations were found with other cognitive tests like the abbreviated MMSE, ACE-III, TMT-A and B, Grober and Buschke Test, Stroop Test, and Boston Test Nomination Test.

Conclusions:

  • Patients with end-stage CKD on hemodialysis exhibit executive function impairment.
  • This impairment is evident even when standard cognitive screenings like the MMSE appear normal.
  • Cognitive deficits in hemodialysis patients warrant further investigation and clinical consideration.

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