Cognitive Impairment in Dialysis and Non-Dialysis Patients Suffering from Chronic Renal Failure and Comparing Them with a Control Group

Abstract

Background: Chronic renal failure and its end-stage disease are one of the most important causes of death and disability, and its prevalence is increasing in the world. This disease can cause many complications in the patients with end- stage renal disease. Objectives: The present study aimed at comparing cognitive impairment in patients with end- stage renal disease (ESRD) and chronic renal failure (CRF) with a control group. Methods: In this cross-sectional study, 85 ESRD, dialysis dependent patients, 200 CRF patients, non-dialysis dependent, as well as 180 patients with high blood pressure or diabetes as control group who referred to Kowsar hospital during 2015 and 2016 were studied. The Persian version of the mini mental status examination (MMSE) questionnaire was used to collect data. It was completed by one of the skilled and trained nurses. Results: The results revealed that 28.2% of ESRD, 1% of CRF patients, and 0.6% of control group patients had severe cognitive impairment. Cognitive health score in ESRD group was lower than that in CRF (P < 0.001) and control group (P < 0.001). In addition, cognitive health score of CRF patients was lower than that in the control group (P = 0.005). ESRD patients had significantly higher impairment in time and place orientation, calculation, recall, language, and repetition compared to control and CRF groups (P < 0.001), but there were no significant differences between control and CRF groups. With respect to complex commands, the control group had a significantly lower impairment, but the other 2 groups were not significantly different in this regard. The three experimental groups were not significantly different in per-test stage. Conclusions: ESRD patients have severe cognitive impairment compared to CRF patients. Therefore, it is recommended that these patients be examined cognitively and proper rehabilitation programs be considered for them.