Study: Episodic, other cognitive functions normalized after kidney transplant
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Key takeaways:
- In the study, episodic memory and verbal declarative memory normalized after transplant.
- Semantic memory, verbal fluency, language and other cognitive functions partly improved.
Episodic and verbal declarative memory normalized in adults on in-center hemodialysis after receiving a kidney transplant, according to study results. Other cognitive impairments also showed improvement.
“Cognitive impairment in kidney disease affects self-esteem, vocational abilities, quality of life, health care costs and mortality,” Aditi Gupta, MD, MS, professor of nephrology and hypertension at University of Kansas Medical Center, wrote with colleagues. “It is not clear whether kidney transplantation (KT) improves cognition and whether the improvement is uniform across cognitive domains. The distinction between reversible and irreversible cognitive impairment has important implications in the clinical care of patients before and after KT.”
Researchers assessed cognition at a dialysis clinic in patients waitlisted for transplant. Patients were evaluated before transplant (n =101), at 3 months post-transplant (n = 78) and at 12 months post-transplant (n = 83).
Standard neuropsychological tests were used to gauge global cognition; episodic and declarative memory; psychomotor speed; visuospatial function; working memory and attention; executive function; and semantic memory, verbal fluency and language.
Before transplant, testing showed patients had low scores in Logical Memory I and II, Digit Symbol Submission Test (DSST), Mini-Mental State Exam, Category Fluency and Digit Span compared with normative values from the National Alzheimer's Coordinating Center.
Logical Memory I and II, Category Fluency and DSST scores improved post-transplant in the study group. Logical Memory I and II scores were similar to normative values after transplant, the researchers noted, while Category Fluency and DSST scores were better but not normative.
“Patients listed for KT have impairments in episodic memory, semantic memory, psychomotor speed, working memory, attention and visuospatial function,” Gupta and researchers wrote. “Episodic memory and verbal declarative memory normalized after KT.
“In addition,” they added, “there are improvements in semantic memory, verbal fluency, language, psychomotor speed, and visuospatial function. This knowledge of differential improvement in cognitive domains after a KT is relevant for clinical decision-making.”
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