6
views
0
recommends
+1 Recommend
1 collections
    0
    shares

      Call for Papers: Green Renal Replacement Therapy: Caring for the Environment

      Submit here before July 31, 2024

      About Blood Purification: 3.0 Impact Factor I 5.6 CiteScore I 0.83 Scimago Journal & Country Rank (SJR)

      • Record: found
      • Abstract: found
      • Article: found

      Cognitive Function and Dialysis Adequacy: No Clear Relationship

      research-article

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background/Aims: Cognitive impairment is common in hemodialysis patients and may be impacted by multiple patient and treatment characteristics. The impact of dialysis dose on cognitive function remains uncertain, particularly in the current era of increased dialysis dose and flux. Methods: We explored the cross-sectional relationship between dialysis adequacy and cognitive function in a cohort of maintenance hemodialysis patients. Adequacy was defined as the average of the 3 most proximate single pool Kt/V assessments. A detailed neurocognitive battery was administered during the 1st hour of dialysis. Multivariable linear regression models were adjusted for age, sex, education, race and other clinical and demographic characteristics. Results: Among 273 patients who underwent cognitive testing, the mean (SD) age was 63 (17) years and the median dialysis duration was 13 months, 47% were woman, 22% were African American, and 48% had diabetes. The mean (SD) Kt/V was 1.51 (0.24). In univariate, parsimonious and multivariable models, there were no significant relationships between decreased cognitive function and lower Kt/V. Conclusion: In contrast to several older studies, there is no association between lower Kt/V and worse cognitive performance in the current era of increased dialysis dose. Future studies should address the longitudinal relationship between adequacy of dialysis and cognitive function to confirm these findings.

          Related collections

          Most cited references22

          • Record: found
          • Abstract: not found
          • Article: not found

          Estimation of Relationships for Limited Dependent Variables

            Bookmark
            • Record: found
            • Abstract: not found
            • Article: not found

            Excerpts from the US Renal Data System 2009 Annual Data Report.

              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Prevalence, recognition, and implications of mental impairment among hemodialysis patients.

              The increasing age and co-morbidity of dialysis patients may be associated with an increase in the prevalence of Alzheimer's disease, stroke, and other causes of mental impairment. We sought to determine the prevalence, recognition, and implications of mental impairment among chronic hemodialysis patients. We administered the Mini Mental Status Exam (MMSE) to 336 randomly selected patients from three dialysis units. To determine recognition of mental impairment by health care providers, we compared MMSE scores with mental status assessments obtained from each patient's dialysis technician and medical record. To determine the clinical implications of mental impairment, we prospectively obtained Kt/V, albumin, protein catabolic rate, blood pressure, and hematocrit values. To determine the resource implications of mental impairment, we assessed staff time required to care for each patient as well as hospitalizations. We found that 22% of subjects had mild mental impairment (MMSE 18 to 23) and that 8% had moderate-severe mental impairment (MMSE 0 to 17). The sensitivity of technician and medical record mental status assessments were 57% and 15%, respectively. After adjusting for demographic and medical variables, low MMSE score was independently associated with low protein catabolic rate (odds ratio, 1.5; P = 0.02), increased technician time caring for patient after dialysis (odds ratio, 1.5; P = 0.005), and increased hospital days (odds ratio, 1.4; P = 0.03). In conclusion, there is a high prevalence of unrecognized mental impairment among hemodialysis patients that has adverse implications for protein nutritional status, staff time, and hospitalization. We recommend that clinicians routinely screen for mental impairment and target impaired patients for interventions to improve mental status and associated adverse outcomes.
                Bookmark

                Author and article information

                Journal
                AJN
                Am J Nephrol
                10.1159/issn.0250-8095
                American Journal of Nephrology
                S. Karger AG
                0250-8095
                1421-9670
                2011
                January 2011
                21 October 2010
                : 33
                : 1
                : 33-38
                Affiliations
                aDivision of Nephrology, bDepartment of Psychiatry, and cBiostatistics Research Center, Tufts Medical Center, Boston, Mass., USA
                Author notes
                *Mark J. Sarnak, MD, MS, Tufts Medical Center, Division of Nephrology, 800 Washington Street, Box 391, Boston, MA 02111 (USA), Tel. +1 617 636 1182, Fax +1 617 636 8329, E-Mail msarnak@tuftsmedicalcenter.org
                Article
                322611 PMC3245831 Am J Nephrol 2011;33:33–38
                10.1159/000322611
                PMC3245831
                21150193
                6ad7dc85-8b4e-4d4a-8c37-11940a9292a1
                © 2010 S. Karger AG, Basel

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                History
                : 08 November 2010
                Page count
                Tables: 3, Pages: 6
                Categories
                Original Report: Patient-Oriented, Translational Research

                Cardiovascular Medicine,Nephrology
                Cognitive function,Dialysis adequacy,Chronic kidney disease
                Cardiovascular Medicine, Nephrology
                Cognitive function, Dialysis adequacy, Chronic kidney disease

                Comments

                Comment on this article