Who should make the decision for renal replacement therapy?

Abstract

Introduction: In this study, we aimed to evaluate cognitive functions in Stage 4 and 5 CKD patients using the Montreal Cognitive Assessment (MoCA) Scale, which objectively assesses cognitive dysfunction and various cognitive functions, and to compare them with a control group with normal kidney functions.

Methods: All participants in our case-control study were administered the Montreal Cognitive Assessment (MoCA) Test, and total scores, subscale scores, and the presence of cognitive dysfunction were recorded.

Results: When the groups were compared in terms of cognitive dysfunction (CD), 12.9% of the control group and 37.1% of the case group were found to have CD, which was statistically significant. When the groups were compared in terms of data and scale scores, the visual construction subscale score, naming, delayed recall subscale score, and total MoCA score were found to be significantly lower in the case group compared to the control group.

Conclusion: Our study is the first to use the MoCA test with the correct reference range. The significant impairment observed in the cognitive functions of patients with advanced-stage CKD in our study suggests that the decision for renal replacement therapy should not be made by the patient alone, as it may be incorrect.