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Kidney transplantation may improve cognitive function among patients with ESRD

Monday, November 17 2008 | Comments
Evidence Grade 7 What's This?
By Kiki Diven

Patients with end-stage renal disease (ESRD) who undergo kidney transplantation may also experience improved cognitive function following the procedure, recent trial outcomes indicate.

"While researchers and clinicians consider cognitive decline to be a common occurrence in patients with chronic kidney disease, it is unclear if this impairment is due to patients' advanced age, their chronic health conditions, or potential treatment-related factors," researchers note. "In addition, the effects of surgery and immunosuppressant medications on memory and overall cognitive performance have been poorly studied, but previous research suggests that kidney transplantation may have a beneficial effect on patients' mental function."

To further investigate, Dr. Mark Unruh of the University of Pittsburgh and his colleagues evaluated the cognitive function of 37 patients with ESRD before and after kidney transplantation. The patients who had a transplant were compared with 23 control patients who did not undergo a kidney transplant but who received dialysis. Patients in the control group underwent cognitive testing at baseline and after progression to ESRD.

The patients were followed up at least 6 months after the transplantation and from 18 months to 24 months from the baseline tests.

Investigators found that kidney transplant recipients had statistically significant improvement on test scores for verbal learning and memory, attention and psychomotor speed and language after surgery.

Furthermore, on the Logical Memory 1 and 2 tests of the Wechsler Memory scale, the patients in the transplant group improved following the surgery but the control subjects declined. Those in the transplant group also demonstrated improvement on a test of working memory, called the Digit Span, but those in the control group showed a decline.

"These findings confirm previous work with smaller numbers of patients and provide longitudinal validation of findings of studies examining only a cross-section of kidney transplant recipients," lead study author Dr. Unruh told Reuters Health. "Furthermore, these findings support the position that kidney transplant provides optimal replacement of renal function and provide an opportunity to improve quality of life and rehabilitation in patients with advanced chronic kidney disease," he added.  (Poster Board TH-PO531).

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