Egbi et al
Greener Journal of Medical Sciences Vol. 5 (1), pp. 019-025, January 2015.
ISSN: 2276-7797 © 2015 Greener Journals
Manuscript Number: 051114384
Cognitive deficits of patients with chronic kidney disease and effect of hemodialysis
Oghenekaro Godwin Egbi1*, Olubunmi Ogunrin2 and Efosa Oviasu2
1Department of Internal Medicine, Niger Delta University Teaching Hospital, Okolobiri, Bayelsa State, Nigeria.
2Department of Internal Medicine, University of Benin Teaching Hospital, Benin City, Edo State, Nigeria.
Corresponding Author’s Email: drkoge@ yahoo. com
Background: Cognitive impairment (CI) has been described in chronic kidney disease (CKD) but the effect of haemodialysis (HD) on cognitive performance of CKD patients has not been researched in Sub-Saharan Africa. We studied the cognitive deficits of CKD patients and the short-term effect of HD on cognitive function in end-stage renal disease (ESRD) patients.
Methods: This was a case-controlled analytical study of one hundred and ninety CKD patients and a hundred control subjects recruited and neuro-psychologically assessed with a computer assisted test battery, the Iron Psychology (acronym – FePsy) pre- and post-hemodialysis.
The study was conducted between December 2009 and July 2010 at a tertiary health facility in cosmopolitan southern Nigeria and involved consecutive patients with clinical evidence of CKD based on symptoms and estimated GFR. Demographic, clinical and biochemical variables were related to cognitive performance using Pearson correlation and multiple regression analysis. The outcome measures were scores of psychomotor speed tasks (simple auditory and visual reaction times), recognition memory tests and sustained attention task (binary choice task). The Iron Psychology (FePsy) was used to assess the simple reaction time, complex reaction time, memory and concentration of the CKD patients and controls.
Results: CKD patients performed worse in tasks of information processing speed and memory but compared favorably with controls in tests of concentration. Advancing age, anemia, uncontrolled systolic blood pressure, acidosis and serum chloride derangement were independently associated with cognitive deficits. Acute HD was only associated with improvement in psychomotor speed.
Conclusion: The CKD patients manifested cognitive impairments in memory and psychomotor tasks. Anemia, uncontrolled blood pressure and biochemical derangements predicted cognitive impairment. HD, in the short term, improved psychomotor speed of the patients.
Keywords: chronic kidney disease, cognitive impairment, endstage renal disease, hemodialysis, iron psychology.
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