Neuropsychological Profile in Older Adults with End-Stage Kidney Disease during Kidney Transplantation Evaluation.

IF 2.1 4区心理学 Q2 PSYCHOLOGY

Archives of Clinical Neuropsychology Pub Date : 2025-01-20 DOI:10.1093/arclin/acaf001

Elodie Pongan, Isabelle Rouch, Julien Vernaudon, Romain Bachelet, Teddy Novais, Marie-Hélène Coste, Arlette Edjolo, Antoine Garnier-Crussard

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Abstract

Background: End-stage chronic kidney disease (CKD) is a significant concern for older adults and is often associated with cognitive impairment (CI). The origin of this CI is multifactorial, involving vascular and metabolic factors. Additionally, renal treatments, including dialysis, may affect cognition. This study aimed to assess the neuropsychological profiles of these patients and understand the effects of dialysis treatment.

Methods: We conducted an observational retrospective study including older adults with end-stage CKD attending for kidney transplantation (KT). Comprehensive neuropsychological assessments were conducted. Composite cognitive scores were computed. Multivariate regression models were used to assess associations between cognition and dialysis status.

Results: We included 223 patients (151 treated with dialysis, 72 with conservative management), mean age of 73.5 ± 3.4. We observed a high prevalence of CI, around 30% for global cognition and affecting all neuropsychological domains. Patients treated with dialysis exhibited lower cognitive performance compared to those not undergoing dialysis, particularly in episodic (p = .031) and working memory (p = .024).

Conclusion: This study confirms the high prevalence of CI in end-stage CKD, with dialysis being associated with worse episodic and working memory compared to non-dialyzed participants. Future investigations are needed to track the long-term cognitive trajectory of patients on the KT waiting list and post-transplantation.

Trial registration: Retrospectively registered, no 22-808 on July 7th, 2022, CNIL register number 22-5808.

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老年终末期肾病患者在肾移植评估中的神经心理特征

背景：终末期慢性肾脏疾病（CKD）是老年人的一个重要问题，通常与认知障碍（CI）相关。这种CI的起源是多因素的，涉及血管和代谢因素。此外，肾脏治疗，包括透析，可能会影响认知。本研究旨在评估这些患者的神经心理特征，并了解透析治疗的效果。方法：我们进行了一项观察性回顾性研究，包括参加肾移植（KT）的老年终末期CKD患者。进行了全面的神经心理评估。计算复合认知得分。多变量回归模型用于评估认知与透析状态之间的关系。结果：纳入223例患者（透析治疗151例，保守治疗72例），平均年龄73.5±3.4岁。我们观察到CI的高患病率，在全球认知中约占30%，并影响所有神经心理领域。与未接受透析治疗的患者相比，接受透析治疗的患者表现出较低的认知表现，特别是在情节（p = 0.031）和工作记忆（p = 0.024）方面。结论：本研究证实了终末期CKD患者CI的高患病率，与非透析患者相比，透析患者的情景记忆和工作记忆更差。未来的研究需要追踪KT等待名单和移植后患者的长期认知轨迹。试验注册：回顾性注册，编号22-808，于2022年7月7日注册，CNIL注册号22-5808。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Archives of Clinical Neuropsychology 医学-心理学

CiteScore

4.60

自引率

7.70%

发文量

358

审稿时长

6-12 weeks

期刊介绍： The journal publishes original contributions dealing with psychological aspects of the etiology, diagnosis, and treatment of disorders arising out of dysfunction of the central nervous system. Archives of Clinical Neuropsychology will also consider manuscripts involving the established principles of the profession of neuropsychology: (a) delivery and evaluation of services, (b) ethical and legal issues, and (c) approaches to education and training. Preference will be given to empirical reports and key reviews. Brief research reports, case studies, and commentaries on published articles (not exceeding two printed pages) will also be considered. At the discretion of the editor, rebuttals to commentaries may be invited. Occasional papers of a theoretical nature will be considered.