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Who should make the decision for renal replacement therapy?
Edip Erkuş1, Rojda Kotan2, Doğan Nasır Binici2
1Nephrology Unit, University of Health Sciences Erzurum City Hospital, Erzurum, Turkey.
The International Journal of Artificial Organs
|March 28, 2025
Summary
Patients with advanced chronic kidney disease (CKD) experience significant cognitive dysfunction, as measured by the Montreal Cognitive Assessment (MoCA) Scale. This cognitive impairment suggests careful consideration is needed when deciding on renal replacement therapy.
Area of Science:
- Nephrology
- Neuroscience
- Psychology
Background:
- Chronic kidney disease (CKD) affects multiple organ systems, including the brain.
- Cognitive impairment is a potential complication in advanced CKD stages.
Purpose of the Study:
- To evaluate cognitive functions in Stage 4 and 5 CKD patients using the Montreal Cognitive Assessment (MoCA) Scale.
- To compare cognitive function in CKD patients with a control group.
Main Methods:
- A case-control study design was employed.
- Participants underwent the MoCA test, with total and subscale scores recorded.
- Cognitive dysfunction (CD) was assessed.
Main Results:
- A significantly higher prevalence of CD was observed in CKD patients (37.1%) compared to controls (12.9%).
- CKD patients exhibited significantly lower scores in visual construction, naming, delayed recall, and total MoCA scores.
- The study utilized the MoCA test with the correct reference range.
Conclusions:
- Advanced-stage CKD is associated with significant impairment in cognitive functions.
- Patient-led decisions regarding renal replacement therapy may be compromised due to cognitive dysfunction.
- This highlights the importance of comprehensive cognitive assessment in CKD management.
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