Cognitive functions and biochemical changes in adult renal patients on dialysis

Abstract

To determine if biochemical fluctuations in the blood may be an independent factor in the level of cognitive function in end-stage renal failure (ESRF) subjects on dialysis, cognitive function was studied in 14 home haemo dialyzed (HHD) and 14 continuous ambulatory peritoneal dialysis (CAPD) subjects by means of a repeatable battery of 8 neuropsychological tests (NP).In addition 2 psychological status variables and 16 biochemical variables were studied on each test session. For HHD subjects this was 2 hours before dialysis, 1 hour after dialysis and 24 hours after dialysis. CAPD subjects were tested morning,midday and afternoon on three sequential days. Biochemical values were found within the expected range for HHD and CAPD patients. For NP tests, impaired scores were only found for the Rey Auditory Verbal Learning Test (RAVLT), while the Object Assembly (WAIS-R) scores were lower than expected for the education level obtained. Despite significant daily changes in biochemical plasma levels in HHD patients, no evidence was found to suggest that well-dialyzed patients undergo daily fluctuations in their cognitive functioning and mostly insignificant correlation between NP functions and biochemical differences was found.