Assessing cognitive dysfunction in the hemodialysis population

cognition;cognitive impairment;hemodialysis (HD);chronic kidney disease;cognitive dysfunction;CogState;chronic kidney disease (CKD);maintenance hemodialysis (MHD)

West, Mason James

关键词: cognition;    cognitive impairment;    hemodialysis (HD);    chronic kidney disease;    cognitive dysfunction;    CogState;    chronic kidney disease (CKD);    maintenance hemodialysis (MHD);   

Others  :  https://www.ideals.illinois.edu/bitstream/handle/2142/78372/WEST-THESIS-2015.pdf?sequence=1&isAllowed=y

美国|英语

来源: The Illinois Digital Environment for Access to Learning and Scholarship

【 摘 要 】

Patients with end stage renal diseases (ESRD) requiring hemodialysis treatment experience cognitive impairment due to a variety of risk factors; most of which stem from chronic kidney disease (CKD) and the dialysis process itself. The purpose of this study was to assess changes in cognitive functioning in maintenance hemodialysis (MHD) patients during a standard hemodialysis (HD) session. MHD patients (n=12) were recruited from local dialysis clinics. Cognitive function was measured using a battery of tests from the CogState and Count Battle programs at 0, 1, and 3hrs into a standard HD treatment. In addition, quality of life and depression questionnaires, heart rate, blood pressure, relative blood volume (BV), hematocrit (HCT), and O2 saturation data was collected for comparison. Significant declines were seen in cognitive domains; specifically long term memory measures over the course of a dialysis session (p<0.05). A trend toward significance was seen in the cognitive measure of working memory and the cardiovascular measure of mean arterial blood pressure. The change in several hemodynamic variables (mean arterial blood pressure, hematocrit, and relative blood volume) were correlated with the change in several measures of cognitive function. In addition, questionnaires evaluating quality of life and depression were correlated with measures of cognitive function. These findings suggest that cognitive impairment in hemodialysis patients is most likely due to a variety of cerebrovascular problems caused by CKD and the hemodialysis process itself. Further studies are needed to determine if other domains are also affected and to pinpoint the primary mechanisms behind these cognitive issues.