Better preservation of cognitive faculty in continuous ambulatory peritoneal dialysis.
We employed the so-called event-correlated potential (ECP) P300, a neurophysiological test which explores the circuits of attention and memory in the brain and is altered in subjects with a dismetabolic or degenerative encephalopathy, in order to evaluate the cognitive faculty in two groups of uremic patients [18 on continuous ambulatory peritoneal dialysis (CAPD), 15 on hemodialysis (HD)] comparable with respect to age and time on dialysis. The values of latency (msec) of P300 resulted in CAPD patients 356 +/- 26 in CZ (central zero electrodes) and 357.5 +/- 25 in PZ (parietal zero electrodes), not significantly different from the values in normal controls (341 +/- 14.5 in CZ and 340 +/- 15.6 in PZ) and in HD patients postdialysis (354 +/- 24.4 in CZ and 354 +/- 25.6 in PZ). On the contrary, the predialytic values of HD patients (384 +/- 25.6 CZ and 385 +/- 25.5 in PZ) were significantly different from the postdialytic values and from the values of CAPD patients and controls (p < 0.01). These results support the conclusion that HD is able to restore a normal cognitive faculty only transiently in the postdialytic phase, while CAPD maintains this important function steadily close to the normal range, thus being clearly better than HD.
Nephrology Unit, Ospedale Silvestrini S. Andrea delle Fratte, Perugia, Italy.
U
U
Buoncristiani
A
A
Alberti
G
G
Gubbiotti
G
G
Mazzotta
V
V
Gallai
G
G
Quintaliani
M
M
Gaburri
D000328:Adult; D000368:Aged; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology*; D005072:Evoked Potentials, Auditory; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010531:Peritoneal Dialysis, Continuous Ambulatory; D006435:Renal Dialysis