title: Impact of Cognitive Function Change on Mortality in Renal Transplant and End-Stage Renal Disease Patients.
abstract: Limited evidence from small-scale studies, mainly involving end-stage renal disease (ESRD) patients, suggests that kidney transplantation may improve cognitive function. We examined changes in cognitive function after a kidney transplant and its association with survival in advanced chronic kidney disease (CKD)/ESRD patients.
  
  
  
  In a prospective study design, cognitive performance of 90 patients (50.6 ± 13.1 years, 66.7% men, 27.8% blacks, 76% CKD stages 4-5) was assessed at the respective patients' residences using established neurocognitive tests.
  
  
  
  Among the 90 patients, 44 received a kidney transplant (KTx group) while 46 did not (no-KTx group). After a mean follow-up of ∼19 months, there was no significant change in scores for majority of cognitive tests in either group. Older age, but not diabetes or renal function status (CKD vs. ESRD), was a determinant of poor follow-up cognitive performance. Additionally, poor attention/psychomotor speed and executive performance (as measured by Trails A and Stroop test, respectively) was associated with higher mortality over a mean follow-up of 4.7 years, even after adjustment for age, sex, diabetes, CKD or ESRD status and kidney transplant status.
  
  
  
  Overall, cognitive function does not significantly improve after kidney transplant or significantly decline in non-transplanted, advanced CKD/ESRD patients. Poor attention, psychomotor speed and executive performance independent of transplant status were associated with higher mortality over time.
authors: Renal-Electrolyte Division, Department of Medicine, University of Pittsburgh, Pittsburgh, Pa., USA.
authors: Akhil
authors: A
authors: Sharma
authors: Jonathan
authors: J
authors: Yabes
authors: Saleem
authors: S
authors: Al Mawed
authors: Christine
authors: C
authors: Wu
authors: Carol
authors: C
authors: Stilley
authors: Mark
authors: M
authors: Unruh
authors: Manisha
authors: M
authors: Jhamb
mesh_terms: D000328:Adult; D000368:Aged; D003071:Cognition; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000401:mortality* / Q000523:psychology / Q000601:surgery; D016030:Kidney Transplantation / Q000401:mortality* / Q000523:psychology; D008297:Male; D008875:Middle Aged; D010414:Pennsylvania / Q000453:epidemiology; D011446:Prospective Studies; D016019:Survival Analysis