Cognitive functioning pre- to post-kidney transplantation--a prospective study.
BACKGROUND
Kidney transplantation (TX) may ameliorate the neuropsychological (NP) impairments in end-stage renal disease (ESRD). Previous studies have suffered from small sample sizes, lack of standardization of dialysis adequacy, and insufficiently sensitive NP tests.


METHODS
Twenty-eight medically stable patients aged 44.04 (12.01) years with ESRD were investigated before and at 6 months after successful kidney TX using an NP test battery, which assessed attention-concentration, psychomotor ability and memory. Formal kinetic modelling of dialysis delivery ensured adequate renal replacement therapy. Transplant function was good on stable doses of immunosuppressive medication, without evidence of rejection at the time of testing.


RESULTS
Within-subject comparisons showed statistically significant improvement in memory performance after kidney TX. Other NP measures (attention-concentration and psychomotor abilities) showed non-significant improvements. Normative comparisons showed NP impairments on dialysis, which were not apparent after TX.


CONCLUSIONS
These data demonstrate improvements in cognition following kidney TX and emphasize the reversibility of the memory problems evidenced in dialysis.
Griva
Konstadina
K
Centre for Behavioural and Social Sciences in Medicine, Division of Medicine, University College London, and Department of Nephrology, Middlesex Hospital, Wolfson Building, 48 Riding House Street, London W1N 8AA, UK.
Thompson
Derek
D
Jayasena
Dakshina
D
Davenport
Andrew
A
Harrison
Michael
M
Newman
Stanton Peter
SP
D000328:Adult; D001288:Attention / Q000502:physiology; D003071:Cognition / Q000502:physiology*; D004569:Electroencephalography; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects / Q000502:physiology* / Q000523:psychology; D008569:Memory Disorders / Q000503:physiopathology / Q000523:psychology; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D011446:Prospective Studies; D006435:Renal Dialysis / Q000009:adverse effects; D013997:Time Factors