Cognitive impairment without dementia in end-stage chronic renal disease. Data from an argentinian center

Abstract

_{Objectives: To assess cognitive performance in a hemodialysis population. To know relationship between IRCT and the presence of cognitive impairment, as well as the influence of hemodialysis treatment. Identify other variables that could influence cognitive performance. Methods: quasi-experimental study design, cross section. 25 adult subjects with ESRD on hemodialysis were included. Control group consisted of 4 healthy subjects. Medical histories, information on dialysis and laboratory tests were recorded. Individual interviews were conducted using the Neuropsi test being performed by a single operator. Results: 36% of patients had alterations in attention and executive functions and 24% had impaired memory. Patients with abnormal results in attention and executive functions had older and proportion of women although not statistically significant, plus higher percentage of hypertension, ischemic heart disease and smoking. This group had lower levels of hematocrit (32.11 ± 4.96 vs 35.69 ± 1.40, p = 0.01) and hemoglobin (10.67 ± 1.55 vs 11.98 ± 0.51, P = <0.01) and a tendency to total cholesterol and lower triglycerides. Patients with abnormal results in memory had a greater number of episodes of hypotension (5.83 ± 2.64 vs 2.63 ± 3.29; p = 0.04), a higher proportion of patients with hypertension (66.7% vs 26.3%; p = 0.07) and more levels low hemoglobin (10.72 ± 1.75 vs 11.76 ± 0.84, P = 0.05); without significant differences in levels of calcium and phosphorus metabolism, PTH, albumin, glucose or lipids. Conclusions: HD patients are a high-risk population and higher prevalence of cognitive disorders. Both comorbid causes associated with chronic vascular disease and inflammation disorders and malnutrition are factors that are associated with worse outcomes.}