Key result
Conservative management in stage 5 CKD is linked to prolonged reaction times versus HD or CAPD.
Why the study?
Cognitive impairment among Stage 5 CKD patients varies with different treatment modalities, and contradicting results have been reported.
Does the modality of treatment (HD, CAPD, or conservative management) affect cognitive function in patients with Stage 5 CKD?
Observational (n=72)
Does the modality of treatment (HD, CAPD, or conservative management) affect cognitive function in patients with Stage 5 CKD?
In patients with Stage 5 CKD, cognitive function is more impaired in those receiving conservative management compared to those undergoing hemodialysis or peritoneal dialysis.
Answers are grounded in this paper and cite their sources.
May associate with worse cognition in stage 5 CKD; hypothesis-generating and should not change practice without prospective data.
Patients with chronic kidney disease (CKD) are at a higher risk of cognitive impairment. Poor quality of life and decreased compliance are frequently observed with cognitive decline among CKD patients. Cognitive impairment among Stage 5 CKD patients varies with different modalities of treatment, and contradicting results have been reported. Fifty-four medically stable Stage 5 CKD patients undergoing different modalities of treatment were recruited: Patients with Stage 5 CKD on maintenance hemodialysis (HD) (n = 18), continuous ambulatory peritoneal dialysis (CAPD) (n = 18), and conservative management (CM) (n = 18). Eighteen apparently healthy participants were recruited as a control group. The cognitive functions assessed were P300 event- related potential, auditory and visual reaction times (VRTs). Kidney function was assessed by serum creatinine and estimated glomerular filtration rate. Creatinine levels were significantly higher in all three treatment groups compared with the control group. Multivariate analysis revealed a significant association between the CKD groups (n = 54) and the parameters of cognitive function. P300 latency was prolonged in all treatment groups compared with the control group and was significantly prolonged in patients on CM compared with HD and CAPD patients. The VRT of CM patients was found to be significantly higher compared with the control group. The auditory reaction time was significantly prolonged in all treatment groups compared with the control group and in the CM group compared with the CAPD group. Cognitive function was more affected in Stage 5 CKD patients on CM compared with patients undergoing HD or CAPD.
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Renugasundari et al. (2023) conducted an observational in Stage 5 Chronic Kidney Disease (n=72). Different treatment modalities (hemodialysis, CAPD, conservative management) vs. Healthy controls and cross-comparison between modalities was evaluated on Cognitive functions assessed by P300 event-related potential, auditory and visual reaction times.
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