title: Risk factors for selective cognitive decline in dialyzed patients with end-stage renal disease: evidence from verbal fluency analysis.
abstract: Although dialyzed patients often have cognitive problems, little is known about the nature of these deficits. We hypothesized that, in contrast to semantic fluency relying mainly on temporal lobes, phonemic fluency, preferentially depending on functions of frontal-subcortical systems, would be particularly sensitive to the constellation of physiological pathological processes associated with end-stage renal disease and dialysis. Therefore, we longitudinally compared phonemic and semantic fluency performance between 49 dialyzed patients and 30 controls. Overall, patients performed below controls only on the phonemic fluency task. Furthermore, their performance on this task declined over time, whereas there was no change in semantic fluency. Moreover, this decline was related to the presence of hypertension and higher blood urea nitrogen. We suggest that these findings may be due to a combination of vascular and topic effects that impact more on fronto-subcortical than temporal lobe networks, but this speculation requires direct confirmation.
authors.affiliation: Institute of Psychology, University of Gdańsk, ul. Bazynskiego 4, Gdańsk, Poland. mharciarek@yahoo.com
authors.forename: Michał
authors.initials: M
authors.lastname: Harciarek
authors.forename: John B
authors.initials: JB
authors.lastname: Williamson
authors.forename: Bogdan
authors.initials: B
authors.lastname: Biedunkiewicz
authors.forename: Monika
authors.initials: M
authors.lastname: Lichodziejewska-Niemierko
authors.forename: Alicja
authors.initials: A
authors.lastname: Dębska-Ślizień
authors.forename: Bolesław
authors.initials: B
authors.lastname: Rutkowski
mesh_terms: D000328:Adult; D000339:Affect / Q000502:physiology; D000368:Aged; D000704:Analysis of Variance; D016022:Case-Control Studies; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D006973:Hypertension / Q000209:etiology; D007676:Kidney Failure, Chronic / Q000628:therapy; D008137:Longitudinal Studies; D008875:Middle Aged; D009483:Neuropsychological Tests; D010700:Phonetics; D006435:Renal Dialysis / Q000009:adverse effects*; D012307:Risk Factors; D012660:Semantics; D014705:Verbal Behavior / Q000502:physiology; D055815:Young Adult