BACKGROUND: Limited evidence from small-scale studies, mainly involving end-stage renal disease (ESRD) patients, suggests that kidney transplantation may improve cognitive function. We examined changes in cognitive function after a kidney transplant and its association with survival in advanced chronic kidney disease (CKD)/ESRD patients. METHODS: In a prospective study design, cognitive performance of 90 patients (50.6 ± 13.1 years, 66.7% men, 27.8% blacks, 76% CKD stages 4-5) was assessed at the respective patients' residences using established neurocognitive tests. RESULTS: Among the 90 patients, 44 received a kidney transplant (KTx group) while 46 did not (no-KTx group). After a mean follow-up of ∼19 months, there was no significant change in scores for majority of cognitive tests in either group. Older age, but not diabetes or renal function status (CKD vs. ESRD), was a determinant of poor follow-up cognitive performance. Additionally, poor attention/psychomotor speed and executive performance (as measured by Trails A and Stroop test, respectively) was associated with higher mortality over a mean follow-up of 4.7 years, even after adjustment for age, sex, diabetes, CKD or ESRD status and kidney transplant status. CONCLUSION: Overall, cognitive function does not significantly improve after kidney transplant or significantly decline in non-transplanted, advanced CKD/ESRD patients. Poor attention, psychomotor speed and executive performance independent of transplant status were associated with higher mortality over time.
BACKGROUND: Limited evidence from small-scale studies, mainly involving end-stage renal disease (ESRD) patients, suggests that kidney transplantation may improve cognitive function. We examined changes in cognitive function after a kidney transplant and its association with survival in advanced chronic kidney disease (CKD)/ESRDpatients. METHODS: In a prospective study design, cognitive performance of 90 patients (50.6 ± 13.1 years, 66.7% men, 27.8% blacks, 76% CKD stages 4-5) was assessed at the respective patients' residences using established neurocognitive tests. RESULTS: Among the 90 patients, 44 received a kidney transplant (KTx group) while 46 did not (no-KTx group). After a mean follow-up of ∼19 months, there was no significant change in scores for majority of cognitive tests in either group. Older age, but not diabetes or renal function status (CKD vs. ESRD), was a determinant of poor follow-up cognitive performance. Additionally, poor attention/psychomotor speed and executive performance (as measured by Trails A and Stroop test, respectively) was associated with higher mortality over a mean follow-up of 4.7 years, even after adjustment for age, sex, diabetes, CKD or ESRD status and kidney transplant status. CONCLUSION: Overall, cognitive function does not significantly improve after kidney transplant or significantly decline in non-transplanted, advanced CKD/ESRDpatients. Poor attention, psychomotor speed and executive performance independent of transplant status were associated with higher mortality over time.
Authors: Mark J Sarnak; Hocine Tighiouart; Tammy M Scott; Kristina V Lou; Eric P Sorensen; Lena M Giang; David A Drew; Kamran Shaffi; James A Strom; Ajay K Singh; Daniel E Weiner Journal: Neurology Date: 2013-01-09 Impact factor: 9.910
Authors: L Kramer; C Madl; F Stockenhuber; W Yeganehfar; E Eisenhuber; K Derfler; K Lenz; B Schneider; G Grimm Journal: Kidney Int Date: 1996-03 Impact factor: 10.612
Authors: Aditi Gupta; Tashra S Thomas; Jeffrey A Klein; Robert N Montgomery; Jonathan D Mahnken; David K Johnson; David A Drew; Mark J Sarnak; Jeffrey M Burns Journal: Nephron Date: 2017-10-20 Impact factor: 3.457
Authors: Aditi Gupta; Jonathan D Mahnken; David K Johnson; Tashra S Thomas; Dipti Subramaniam; Tyler Polshak; Imran Gani; G John Chen; Jeffrey M Burns; Mark J Sarnak Journal: BMC Nephrol Date: 2017-05-12 Impact factor: 2.388
Authors: Patrick J Smith; Gregory L Stonerock; Krista K Ingle; Caroline K Saulino; Benson Hoffman; Brian Wasserman; James A Blumenthal; Scott M Palmer; Jacob A Klapper; Matthew G Hartwig; Valentine R Esposito; Laurie D Snyder Journal: Transplant Direct Date: 2018-03-19
Authors: Marit S van Sandwijk; Ineke J M Ten Berge; Matthan W A Caan; Marco Düring; Willem A van Gool; Charles B L M Majoie; Henk-Jan M M Mutsaerts; Ben A Schmand; Anouk Schrantee; Leo M J de Sonneville; Frederike J Bemelman Journal: Transplant Direct Date: 2020-02-10