The impact of cognitive impairment on dialysis patients

Introduction: Cognitive impairment in End Stage Renal Disease (ESRD) patients is common and often undiagnosed with recent studies suggesting a 2-7 fold higher prevalence of cognitive impairment in ESRD compared with control groups [1]. Since there is a high rate of cognitive impairment in ESRD patients, it is possible that decreased compliance with dialysis treatments may be related to cognitive issues. Nonadherence with diet or fluid restriction measured by interdialytic weight gain (IWG) may lead to worsening of the disease and a higher risk of hospitalization [2, 3]. To be able to assess cognition more easily in patients we designed a Self-Administered Gerocognitive Examination (SAGE) [4] requiring no special equipment and no administrator. Methods: English speaking ESRD dialysis patients completed SAGE and MMSE tests. The following data was collected: vital signs, weight, and interdialytic weight gain (IWG). Correlation methods were used to compare the subjects' scores on the SAGE and MMSE to their interdialytic weight gain (IWG). Results: The preliminary data was collected using 19 subjects with no significant relationship between SAGE and IWG (p = 0.36); numerical value of correlation coefficient is 0.23, much higher than that for the MMSE (0.08). Conclusion: SAGE test seems to be a promising tool in detecting cognitive impairment in ESRD patients. More research is needed increasing the numbers in the sample.