Cognitive Dysfunction in Chronic Renal Disease: Impact of Dialysis Modality

OBJECTIVE: Cognitive dysfunction (CD) is common among patients with chronic kidney disease (CKD) and contributes to morbidity and mortality. We aimed to explore the factors involved in the development of CD in patients with CKD and to compare cognitive function between hemodialysis (HD) and peritoneal dialysis (PD) patients.

MATERIAL and METHODS: We studied 122 patients with different stages of CKD, and divided them into two groups: Predialysis Group: included 60 CKD patients, (28 stage III and 34 stage IV); Dialysis Group: included 60 patients on dialysis therapy, (30 on HD and 30 on PD). Psychometric tests were done all patients. The results were compared with 41 healthy subjects.

RESULTS: We found that the CD rate was higher in patients with CKD (24.6%) than controls (0%, p<0.001). The Mini Mental Test score was found to be correlated with age (r=-0.428), hemoglobin (r=0.336), CRP (r=-0.311), and albumin (r=0.336); the Calculation Test score was found to be correlated with LDL cholesterol (r=-0.336); the Praxis Test Score was found to be correlated with duration of CKD (r=-0.204), HDL (r=0.188); and the Visual Memory Test score was found to be correlated with parathormone levels (r=-0.270). We found the CD rate to be higher in patients on HD (50%) than on PD (23.3%, p=0.032).

CONCLUSION: Our findings suggest that anemia, malnutrition and inflammation play an important role in the development of CD in our patients, and cognitive functions are better preserved in the PD group than the HD group.