Neuropsychological deficits associated with uraemic encephalopathy. A report of 5 patients.
Although uraemic patients with end-stage renal disease (ESRD) often present with impaired cognitive functions, little information exists concerning the identification of some of the neuropsychological processes underlying overt behaviour that affect adjustment to ESRD. The results of a neuropsychological investigation of a sample of adult patients with ESRD, before being accepted for dialysis, is documented in order to determine their altered neuropsychological status, since this may have a bearing on patient management and compliance. The patients were assessed by a single-case study methodology and the Luria-Nebraska Neuropsychological Battery in which parts requiring verbal patient response were taped for later detailed analysis. Neuropsychological complications occurred in conjunction with high urea levels in all patients, indicating varying degrees of impaired performance in motor tactile, receptive language, arithmetic, and intellectual functions. A common underlying pattern of performance decrement revolved around disturbed spatial synthesis and orientation in relation to visual perception, activity, logical-grammatical and arithmetical operations, and in intellectual tasks requiring identification of visual signs and spatial organisation. Further research is necessary to establish a possible correlation between physiological, biochemical and neuropsychological indices, and to compare neuropsychological differences between patients on different forms of treatment for ESRD.
Bosch
B A
BA
Department of Psychiatry, University of Natal, Durban.
Schlebusch
L
L
D000328:Adult; D001928:Brain Diseases, Metabolic / Q000150:complications*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications; D008182:Luria-Nebraska Neuropsychological Battery; D008297:Male; D008875:Middle Aged; D011596:Psychomotor Disorders / Q000209:etiology*; D006435:Renal Dialysis; D014511:Uremia / Q000150:complications*