Temporal effects of dialysis on cognitive functioning in patients with ESRD.
BACKGROUND
Although dialysis has been shown to improve cognitive deficits resulting from uremia, little is known about potential temporal variations in cognitive measures between hemodialysis treatments.


METHODS
We studied dialysis patients for possible fluctuations in attention and memory by using repeatable neuropsychological measures. Twenty patients undergoing hemodialysis on a thrice-weekly dialysis schedule were assessed at intervals of 1, 24, and 67 hours after the last weekly hemodialysis session. For purposes of comparison, we also studied 10 patients on continuous ambulatory peritoneal dialysis (CAPD) therapy at similar intervals.


RESULTS
CAPD patients showed overall stable performance on measures of attention and memory. However, hemodialysis patients showed significant changes (P < 0.05) in auditory memory for both immediate and delayed recall, with the greatest impairment occurring 67 hours postdialysis. Hemodialysis patients also showed a significant change (P < 0.05) in attention between the second and third test periods, ie, 24 to 67 hours postdialysis, with the greatest impairment seen at the 67-hour assessment time. No relationship was found between performance on measures of cognition and levels of postdialysis fatigue in hemodialysis patients.


CONCLUSIONS
CAPD patients showed cognitive stability, whereas hemodialysis patients showed temporal fluctuations in cognitive performance.
Williams
Mark A
MA
Environmental Neuropsychology Laboratory, State University of New York at Binghamton, Binghamton, NY, USA.
Sklar
Allan H
AH
Burright
Richard G
RG
Donovick
Peter J
PJ
D000328:Adult; D003071:Cognition; D005221:Fatigue; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010531:Peritoneal Dialysis, Continuous Ambulatory; D006435:Renal Dialysis