Cognitive performance before and during hemodialysis: a randomized cross-over trial

Nephron Clin Pract. 2013;124(3-4):151-8. doi: 10.1159/000356393. Epub 2013 Dec 3.

Abstract

Background and aims: Hemodialysis (HD) patients are educated and counseled during the HD procedure. There are few studies assessing whether cognitive performance varies with dialysis.

Methods: Using a randomized cross-over design, 40 patients were assigned to one of two sequences: testing 1 h before dialysis followed 1 month later by testing during the first hour of dialysis (n = 21) versus testing during the first hour of dialysis followed 1 month later by 1 h before dialysis (n = 19). Cognitive tests were administered at each testing period. Mixed regression models evaluated for a dialysis effect (difference between test performance before vs. during dialysis) while adjusting for potential learning (difference between first and second tests).

Results: In models accounting for period of testing, there was no difference in test performance between 1 h before versus during the first hour of HD for all administered cognitive tests (p > 0.05). A learning effect was detected between first and second test administration in two tests, specifically, the Word List Learning and the Digit Symbol Substitution Test.

Conclusions: We found no difference in cognitive performance depending on the time of testing, suggesting that cognitive tests performed during the first hour of dialysis are a valid assessment of cognitive performance.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Cognition Disorders / diagnosis*
  • Cognition Disorders / etiology
  • Cognition Disorders / psychology
  • Cognition* / physiology
  • Cross-Over Studies
  • Female
  • Humans
  • Kidney Failure, Chronic / psychology
  • Kidney Failure, Chronic / therapy*
  • Male
  • Middle Aged
  • Neuropsychological Tests*
  • Renal Dialysis* / adverse effects