Cognitive Impairment Early After Initiating Maintenance Hemodialysis: A Cross Sectional Study

Melissa Schorr; Mariah Zalitach; Cindy House; Janice Gomes; Conor J Wild; Fabio R Salerno; Christopher McIntyre

doi:10.3389/fneur.2022.719208

Cognitive Impairment Early After Initiating Maintenance Hemodialysis: A Cross Sectional Study

Front Neurol. 2022 Mar 15:13:719208. doi: 10.3389/fneur.2022.719208. eCollection 2022.

Authors

Melissa Schorr^{1

2}, Mariah Zalitach³, Cindy House³, Janice Gomes^{3

4}, Conor J Wild⁵, Fabio R Salerno^{3

6}, Christopher McIntyre^{1

3

6}

Affiliations

¹ Division of Nephrology, Department of Medicine, London Health Sciences Centre, London, ON, Canada.
² Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
³ The Lilibeth Caberto Kidney Clinical Research Unit, London Health Sciences Centre, London, ON, Canada.
⁴ Department of Pathology and Laboratory Medicine, University of Western Ontario, London, ON, Canada.
⁵ Brain and Mind Institute, University of Western Ontario, London, ON, Canada.
⁶ Department of Medical Biophysics, Western University, London, ON, Canada.

Abstract

Background: Abnormalities in cognitive function are almost universal in patients receiving hemodialysis (HD) and are associated with worse quality of life, impaired decision making, increased healthcare utilization and mortality. While cognitive impairment in the HD population is increasingly recognized, it is unclear how quickly it develops after starting HD.

Methods: This was a cross-sectional study of a cohort of low dialysis vintage HD patients (<12 months). We used the validated Cambridge Brain Science (CBS) battery of web-based tests to evaluate cognition compared to age- and sex matched controls across three cognitive domains: verbal processing, reasoning and short-term memory.

Results: Forty-nine HD patients were included in this study; 43 completed the full battery of tests. The average scores for HD patients were consistently below the age and sex-matched controls. Fifty-five percent of HD patients had cognitive impairment in verbal skills, 43% in reasoning and 18% in short-term memory.

Conclusions: There is a high prevalence of CI evident early after starting HD, with the largest deficits seen in reasoning and verbal processing. These deficits may be attributable to the HD treatment itself. Further studies are needed to characterize the natural history of CI in this patient population and to test interventions aimed at preventing or slowing its progression.

Keywords: Cambridge Brain Sciences; cognitive domains; cognitive impairment; hemodialysis; memory; reasoning; verbal.