Kognitivne sposobnosti bolnikov na hemodializnem zdravljenju
DOI:
https://doi.org/10.20419/2025.34.602Ključne besede:
kognitivne sposobnosti, hemodializno zdravljenje, kronična ledvična bolezenPovzetek
Zdravljenje s hemodializo prinaša v življenja bolnikov mnogo sprememb, zdravstvenih zapletov in zahtev po prilagajanju. Bolniki s kronično ledvično boleznijo imajo pogosto težave tudi s kognitivnim delovanjem, ki se z napredovanjem bolezni poglabljajo. Namen naše raziskave je bil oceniti kognitivne sposobnosti bolnikov na hemodializnem zdravljenju. V raziskavo je bilo vključenih 44 udeležencev iz programa kronične hemodialize v dializnem centru Kliničnega oddelka za nefrologijo Univerzitetnega kliničnega centra Ljubljana. Kognitivne sposobnosti udeležencev smo ocenili s testno baterijo preizkusov, v katero je bil vključen presejalni preizkus za ocenjevanje splošnega kognitivnega delovanja, preizkusi ocenjevanja pozornosti (hitrosti odzivanja, selektivne pozornosti in deljene pozornosti), hitrosti procesiranja in izvršilnih sposobnosti. Rezultati so pokazali, da ima več kot polovica bolnikov v vzorcu težave s kognitivnimi sposobnostmi (52 % posameznikov je pri presejalnem preizkusu splošnih kognitivnih sposobnosti doseglo rezultat, nižji od mejne vrednosti), oškodovano hitrost odzivanja je imelo 35 % bolnikov, psihomotorična hitrost in izvršilne sposobnosti so bile znižane v posameznih starostnih skupinah udeležencev. Ugotovitve so skladne z raziskavami iz tujine, ki prav tako ugotavljajo težave s kognitivnimi sposobnostmi pri bolnikih, ki se zdravijo s hemodializo. Rezultati raziskave predstavljajo izhodišče za razvoj in preverjanje učinkovitosti ukrepov za preprečevanje kognitivnega upada pri bolnikih na hemodializnem zdravljenju.
Prenosi
Literatura
Altmann, P., Barnett, M. E. in Finn, W. F. (2007). Cognitive function in Stage 5 chronic kidney disease patients on hemodialysis: No adverse effects of lanthanum carbonate compared with standard phosphate-binder therapy. Kidney International, 71(3), 252–259. https://doi.org/10.1038/sj.ki.5001932
Bogataj, Š., Kurnik Mesarič, K., Pajek, M., Petrušič, T. in Pajek, J. (2022). Physical exercise and cognitive training interventions to improve cognition in hemodialysis patients: A systematic review. Frontiers in Public Health, 10, članek 1032076. https://doi.org/10.3389/fpubh.2022.1032076
Bowie, C. R. in Harvey, P. D. (2006). Administration and interpretation of the Trail Making Test. Nature Protocols, 1(5), 2277–2281. https://doi.org/10.1038/nprot.2006.390
Bucharles, S. G. E., Wallbach, K. K. S., Moraes, T. P. in Pecoits-Filho, R. (2019). Hypertension in patients on dialysis: Diagnosis, mechanisms, and management. Jornal Brasileiro de Nefrologia, 41(3), 400–411. https://doi.org/10.1590/2175-8239-jbn-2018-0155
Bugnicourt, J. M., Godefroy, O., Chillon, J. M., Choukroun, G. in Massy, Z. A. (2013). Cognitive disorders and dementia in CKD: The neglected kidney-brain axis. Journal of the American Society of Nephrology, 24(3), 353–363. https://doi.org/10.1681/ASN.2012050536
Buturović Ponikvar, J. (2014). Nadomestno zdravljenje s hemodializo [Replacement treatment with hemodialysis]. V J. Lindič, D. Kovač, R. Kveder, M. Malovrh, J. Pajek, A. Aleš Rigler in A. Škoberne (ur.), Bolezni ledvic (str. 683–694). Slovensko zdravniško društvo, Slovensko nefrološko društvo; Univerzitetni klinični center Ljubljana: Klinični oddelek za nefrologijo.
Carvalho, A., Rea, I. M., Parimon, T. in Cusack, B. J. (2014). Physical activity and cognitive function in individuals over 60 years of age: A systematic review. Clinical Interventions in Aging, 9, 661–682. https://doi.org/10.2147/CIA.S55520
Centofani, C. C. (1975). Selected somatosensory and cognitive test performances as a function of age and education in normal and neurologically impaired adults [Neobjavljena doktorska disertacija]. University of Michigan.
Chiu, Y.-L., Tsai, H.-H., Lai, Y.-J., Tseng, H.-Y., Wu, Y.- W., Peng, Y.-S., Chiu, C.-M. in Chuang, Y.-F. (2019). Cognitive impairment in patients with end-stage renal disease: Accelerated brain aging? Journal of the Formosan Medical Association, 118(5), 867–875. https://doi.org/10.1016/j.jfma.2019.01.011
Chu, N. M. in McAdams-DeMarco, M. A. (2019). Exercise and cognitive function in patients with end-stage kidney disease. Seminars in Dialysis, 32(4), 283–290. https://doi.org/10.1111/sdi.12804
Crowe, S. F. (1998). Speed to performance on parts A and B of the Trail Making Test. Journal of Clinical Psychology, 54(5), 585–591.
Cui, L., Chen, W., Yu, X. in Ju, C. (2020). The relationship between cognitive function and having diabetes in patients treated with hemodialysis. International Journal of Nursing Sciences, 7(1), 60–65. https://doi.org/10.1016/j.ijnss.2019.12.003
Dixit, A., Dhawan, S., Raizada, A., Yadav, A., Vaney, N. in Kalra, O. P. (2013). Attention and information processing in end stage renal disease and effect of hemodialysis: A bedside study. Renal Failure, 35(9), 1246–1250. https://doi.org/10.3109/0886022X.2013.819768
Ebaid, D., Crewther, S. G., MacCalman, K., Brown, A. in Crewther, D. P. (2017). Cognitive processing speed across the lifespan: Beyond the influence of motor speed. Frontiers in Aging Neuroscience, 9, članek 62. https://doi.org/10.3389/fnagi.2017.00062
Eckert, M. A., Keren, N. I., Roberts, D. R., Calhoun, V. D. in Harris, K. C. (2010). Age-related changes in processing speed: Unique contributions of cerebellar and prefrontal cortex. Frontiers in Human Neuroscience, 4, članek 10. https://doi.org/10.3389/neuro.09.010.2010
Elias, M. F., Elias, P. K., Seliger, S. L., Narsipur, S. S., Dore, G. A. in Robbins, M. A. (2009). Chronic kidney disease, creatinine and cognitive functioning. Nephrology Dialysis Transplantation, 24(8), 2446–2452. https://doi.org/10.1093/ndt/gfp107
Erickson, K. I., Hillman, C., Stillman, C. M., Ballard, R. M., Bloodgood, B., Conroy, D. E., Macko, R., Marquez, D. X., Petruzzello, S. J. in Powell, K. E. (2019). Physical activity, cognition, and brain outcomes: A review of the 2018 physical activity guidelines. Medicine and Science in Sports and Exercise, 51(6), 1242–1251. https://doi.org/10.1249/MSS.0000000000001936
Ferguson, H. J., Brunsdon, V. E. A. in Bradford, E. E. F. (2021). The developmental trajectories of executive function from adolescence to old age. Scientific Reports, 11, članek 1382. https://doi.org/10.1038/s41598-020-80866-1
Guo, Y., Tian, R., Ye, P., Li, X., Li, G., Lu, F., Ma, Y., Sun, Y., Wang, Y., Xiao, Y., Zhang, Q., Zhao, X., Zhao, H. in Luo, Y. (2022). Cognitive domain impairment and all-cause mortality in older patients undergoing hemodialysis. Frontiers in Endocrinology, 13, članek 828162. https://doi.org/10.3389/fendo.2022.828162
Han, F., Luo, C., Lv, D., Tian, L. in Qu, C. (2022). Risk factors affecting cognitive impairment of the elderly aged 65 and over: A cross-sectional study. Frontiers in Aging Neuroscience, 14, članek 903794. https://doi.org/10.3389/fnagi.2022.903794
Helvik, A. S., Barca, M. L., Bergh, S., Šaltyte-Benth, J., Kirkevold, Ø. in Borza, T. (2019). The course of depressive symptoms with decline in cognitive function - A longitudinal study of older adults receiving in-home care at baseline. BMC Geriatrics, 19(1), članek 231. https://doi.org/10.1186/s12877-019-1226-8
Hill, N. T. M., Mowszowski, L., Naismith, S. L., Chadwick, V. L., Valenzuela, M. in Lampit, A. (2017). Computerized cognitive training in older adults with mild cognitive impairment or dementia: A systematic review and meta-analysis. American Journal of Psychiatry, 174(4), 329– 340. https://doi.org/10.1176/appi.ajp.2016.1603036
Johansson, M. M., Marcusson, J. in Wressle, E. (2015). Cognitive impairment and its consequences in everyday life: Experiences of people with mild cognitive impairment or mild dementia and their relatives. International Psychogeriatrics, 27(6), 949–958. https://doi.org/10.1017/S1041610215000058
Khan, A., Khan, A. H., Adnan, A. S., Sulaiman, S. A. S. in Mushtaq, S. (2019). Prevalence and predictors of depression among hemodialysis patients: A prospective follow-up study. BMC Public Health, 19(1), članek 531. https://doi.org/10.1186/s12889-019-6796-z
Kidney Disease Improving Global Outcomes. (2013). KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney International Suplements, 3(1), 1–150.
Kovesdy, C. P. (2022). Epidemiology of chronic kidney disease: An update 2022. Kidney International Supplements, 12(1), 7–11. https://doi.org/10.1016/j.kisu.2021.11.003
Kurella, M., Chertow, G. M., Luan, J. in Yaffe, K. (2004). Cognitive impairment in chronic kidney disease. Journal of the American Geriatrics Society, 52(11), 1863–1869. https://doi.org/10.1111/j.1532-5415.2004.52508.x
Kurella, M., Mapes, D. L., Port, F. K. in Chertow, G. M. (2006). Correlates and outcomes of dementia among dialysis patients: The dialysis outcomes and practice patterns study. Nephrology Dialysis Transplantation, 21(9), 2543–2548.
Kurella Tamura, M. (2009). Incidence, management, and outcomes of end-stage renal disease in the elderly. Current Opinion in Nephrology and Hypertension, 18(3), 252– 257. https://doi.org/10.1097/MNH.0b013e328326f3ac
Kurella Tamura, M. in Yaffe, K. (2011). Dementia and cognitive impairment in ESRD: Diagnostic and therapeutic strategies. Kidney International, 79(1), 14– 22. https://doi.org/10.1038/ki.2010.336
Kwan, E., Draper, B., Endre, Z. H., Harvey, S. B. in Brown, M. A. (2021). Prevalence, types and recognition of cognitive impairment in dialysis patients in South Eastern Sydney. Internal Medicine Journal, 51(12), 2034–2041. https://doi.org/10.1111/imj.14976
Lateef, A. (2022). Psychological impact of chronic kidney disease and hemodialysis: Narrative review. Psychosomatic Medicine Research, 4(2), 1–5. https://doi.org/10.53388/202210
Lightfoot, C. J., Wilkinson, T. J., Song, Y., Burton, J. O. in Smith, A. C. (2021). Perceptions of exercise benefits and barriers: The influence on physical activity behaviour in individuals undergoing haemodialysis and peritoneal dialysis. Journal of Nephrology, 34(6), 1961–1971. https://doi.org/10.1007/s40620-021-01024-y
Livingston, G., Huntley, J., Sommerlad, A., Ames, D., Ballard, C., Banerjee, S., Brayne, C., Burns, A., Cohen-Mansfield, J., Cooper, C., Costafreda, S. G., Dias, A., Fox, N., Gitlin, L. N., Howard, R., Kales, H. C., Kivimäki, M., Larson, E. B., Ogunniyi, A., … Mukadam, N. (2020). Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. The Lancet, 396(10248), 413–446. https://doi.org/10.1016/S0140-6736(20)30367-6
Lok, C. E., Oliver, M. J., Rothwell, D. M. in Hux, J. E. (2004). The growing volume of diabetes-related dialysis: A population based study. Nephrology Dialysis Transplantation, 19(12), 3098–3103. https://doi.org/10.1093/ndt/gfh540
Lote, C. J. (2012). Principles of renal physiology (5. izd.). Springer.
Malovrh, M. (2014). Vodenje bolnika s kronično ledvično boleznijo [Management of the patient with chronic kidney disease]. V J. Lindič, D. Kovač, R. Kveder, M. Malovrh, J. Pajek, A. Aleš Rigler in A. Škoberne (ur.), Bolezni ledvic (str. 559–568). Slovensko zdravniško društvo, Slovensko nefrološko društvo; Univerzitetni klinični center Ljubljana: Klinični oddelek za nefrologijo.
Marrocos, M. S. M., Teixeira, A. A., Quinto, B. M., Canzian, M. E. F., Manfredi, S. in Batista, M. C. (2022). Diabetes acts on mortality in hemodialysis patients predicted by asymmetric dimethylarginine and inflammation. Nefrología, 42(2), 177–185. https://doi.org/10.1016/j.nefro.2021.02.006
McAdams-DeMarco, M. A., Konel, J., Warsame, F., Ying, H., Fernández, M. G., Carlson, M. C., Fine, D. M., Appel, L. J. in Segev, D. L. (2018). Intradialytic cognitive and exercise training may preserve cognitive function. Kidney International Reports, 3(1), 81–88. https://doi.org/10.1016/j.ekir.2017.08.006
Mór Fukushima, R. L., Micali, P. N., Do Carmo, E. G., De Souza Orlandi, F. in Costa, J. L. R. (2019). Cognitive abilities and physical activity in chronic kidney disease patients undergoing hemodialysis. Dementia e Neuropsychologia, 13(3), 329–334. https://doi. org/10.1590/1980-57642018dn13-030010
Moreels, T., Van de Velde, D., Van Duyse, S., Vanden Wyngaert, K., Leune, T., Van Biesen, W. in De Vriendt, P. (2023). The impact of in-centre haemodialysis treatment on the everyday life of older adults with end-stage kidney disease: A qualitative study. Clinical Kidney Journal, 16(10), 1674–1683. https://doi.org/10.1093/ckj/sfad104
Murali, K. M., Mullan, J., Roodenrys, S., Hassan, H. I. C. in Lonergan, M. (2021). Changes in measures of cognitive function in patients with end-stage kidney disease on dialysis and the effect of dialysis vintage: A longitudinal cohort study. PLoS ONE, 16(5), članek e0252237. https://doi.org/10.1371/journal.pone.0252237
Murray, A. M. (2008). Cognitive impairment in the aging dialysis and chronic kidney disease populations: An occult burden. Advances in Chronic Kidney Disease, 15(2), 123–132. https://doi.org/10.1053/j.ackd.2008.01.010
Murtagh, F. E. M., Addington-Hall, J. in Higginson, I. J. (2007). The prevalence of symptoms in end-stage renal disease: A systematic review. Advances in Chronic Kidney Disease, 14(1), 82–99. https://doi.org/10.1053/j.ackd.2006.10.001
Nasreddine, Z. S., Phillips, N. A., Bédirian, V., Charbonneau, S., Whitehead, V., Collin, I., Cummings, J. L. in Chertkow, H. (2005). The Montreal Cognitive Assessment, MoCA: A brief screening tool for mild cognitive impairment. Journal of the American Geriatrics Society, 53(4), 695– 699. https://doi.org/10.1111/j.1532-5415.2005.53221.x
National Kidney Foundation. (2002). Clinical practice guidelines for chronic kidney disease: Evaluation, classification and stratification.
Noguchi, Y., Ito, M., Mushika, M., Ito, T. in Kawamura, N. (2020). The effect of n-back training during hemodialysis on cognitive function in hemodialysis patients: A non-blind clinical trial. Renal Replacement Therapy, 6 (1), članek 38. https://doi.org/10.1186/s41100-020-00288-7
Novak, A., Vizjak, K., Gacnik, A. in Rakusa, M. (2023). Cognitive impairment in people with epilepsy: Montreal Cognitive Assessment (MoCA) as a screening tool. Acta Neurologica Belgica, 123(2), 451–456. https://doi.org/10.1007/s13760-022-02046-4
Nyberg, J., Henriksson, M., Wall, A., Vestberg, T., Westerlund, M., Walser, M., Eggertsen, R., Danielsson, L., Kuhn, H. G., Åberg, N. D., Waern, M. in Åberg, M. (2021). Anxiety severity and cognitive function in primary care patients with anxiety disorder: A cross-sectional study. BMC Psychiatry, 21, članek 617. https://doi.org/10.1186/s12888-021-03618-z
Odagiri, G., Sugawara, N., Kikuchi, A., Takahashi, I., Umeda, T., Saitoh, H., Yasui-Furukori, N. in Kaneko, S. (2011). Cognitive function among hemodialysis patients in Japan. Annals of General Psychiatry, 10, 10–20. https://doi.org/10.1186/1744-859X-10-20
O’Lone, E., Connors, M., Masson, P., Wu, S., Kelly, P. J., Gillespie, D., Parker, D., Whiteley, W., Strippoli, G. F. M., Palmer, S. C., Craig, J. C. in Webster, A. C. (2016). Cognition in people with end-stage kidney disease treated with hemodialysis: A systematic review and meta-analysis. American Journal of Kidney Diseases, 67(6), 925–935. https://doi.org/10.1053/j.ajkd.2015.12.028
Otobe, Y., Hiraki, K., Hotta, C., Nishizawa, H., Izawa, K. P., Taki, Y., Imai, N., Sakurada, T. in Shibagaki, Y. (2019). Mild cognitive impairment in older adults with pre-dialysis patients with chronic kidney disease: Prevalence and association with physical function. Nephrology, 24(1), 50–55. https://doi.org/10.1111/nep.13173
Paterniti, S., Verdier-Taillefer, M. H., Dufouil, C. in Alpérovitch, A. (2002). Depressive symptoms and cognitive decline in elderly people: Longitudinal study. British Journal of Psychiatry, 181, 406–410. https://doi. org/10.1192/bjp.181.5.406
Perneczky, R. (2021). Dementia treatment versus prevention. Dialogues in Clinical Neuroscience, 21(1), 43–51. https://doi.org/10.31887/DCNS.2019.21.1/rperneczky
Peskar, M., Šimunič, B., Šlosar, L., Pišot, S., Teraž, K., Gasparini, M., Pišot, R. in Marusic, U. (2023). Effects of COVID-19 on cognition and mood after hospitalization and at 2-month follow-up. Frontiers in Psychology, 14, članek 1141809. https://doi.org/10.3389/fpsyg.2023.1141809
Potocnik, J., Ovcar Stante, K. in Rakusa, M. (2020). The validity of the Montreal cognitive assessment (MoCA) for the screening of vascular cognitive impairment after ischemic stroke. Acta Neurologica Belgica, 120(3), 681– 685. https://doi.org/10.1007/s13760-020-01330-5
Richardson, E. D. in Marottoli, R. A. (1996). Education-specific normative data on common neuropsy-chological indices for individuals older than 75 Years. The Clinical Neuropsychologist, 10(4), 375–381. https://doi.org/10.1080/13854049608406698
Robinson, O. J., Vytal, K., Cornwell, B. R. in Grillon, C. (2013). The impact of anxiety upon cognition: Perspectives from human threat of shock studies. Frontiers in Human Neuroscience, 7 , članek 203. https://doi.org/10.3389/fnhum.2013.00203
Şahin, Z. A. (2019). Adaptation of dialysis patients to activities of daily life and evaluation of quality of life. International Archives of Nursing and Health Care, 5(2), 127–132. https://doi.org/10.23937/2469-5823/1510127
Sarnak, M. J., Tighiouart, H., Scott, T., Lou, K. V., Sorensen, E. P., Giang, L. M., Drew, D. A., Shaffi, K., Strom, J. A., Singh, A. K., Weiner, D. E. in Weiner, D. E. (2013). Frequency of and risk factors for poor cognitive performance in hemodialysis patients. Neurology, 80(5), 471–480. https://doi.org/10.1212/WNL.0b013e31827f0f7f
Sehgal, A. R., Grey, S. F., DeOreo, P. B. in Whitehouse, P. J. (1997). Prevalence, recognition, and implications of mental impairment among hemodialysis patients. American Journal of Kidney Diseases, 30(1), 41–49. https://doi.org/10.1016/s0272-6386(97)90563-1
Shanmukham, B., Varman, M., Subbarayan, S., Sakthivadivel, V., Kaliappan, A., Gaur, A. in Jyothi, L. (2022). Depression in patients on hemodialysis: A dilapidated facet. Cureus, 14(9), članek e29077. https://doi.org/10.7759/cureus.29077
Smith, A. (1973). Symbol Digit Modalities Test Manual. Western Psychological Services.
Teixeira, C. V. L., Gobbi, L. T. B., Corazza, D. I., Stella, F., Costa, J. L. R. in Gobbi, S. (2012). Non-pharmacological interventions on cognitive functions in older people with mild cognitive impairment (MCI). Archives of Gerontology and Geriatrics, 54(1), 175–180. https://doi.org/10.1016/j.archger.2011.02.014
Tombaugh, T. N. (2004). Trail Making Test A and B: Normative data stratified by age and education. Archives of Clinical Neuropsychology, 19(2), 203–214. https://doi.org/10.1016/S0887-6177(03)00039-8
Tuokko, H., Morris, C. in Ebert, P. (2005). Mild cognitive impairment and everyday functioning in older adults. Neurocase, 11(1), 40–47. https://doi.org/10.1080/13554790490896802
Um-e-Kalsoom, Khan, S. in Ahmad, I. (2020). Impact of hemodialysis on the wellbeing of chronic kidney diseases patients: A pre-post analysis. Middle East Current Psychiatry, 27, članek 54. https://doi.org/10.1186/s43045-020-00060-x
van Zwieten, A., Wong, G., Ruospo, M., Palmer, S. C., Teixeira-Pinto, A., Barulli, M. R., Iurillo, A., Saglimbene, V., Natale, P., Gargano, L., Murgo, M., Loy, C. T., Tortelli, R., Craig, J. C., Johnson, D. W., Tonelli, M., Hegbrant, J., Wollheim, C., Logroscino, G., … Moscardelli, L. (2019). Associations of cognitive function and education level with all-cause mortality in adults on hemodialysis: Findings from the COGNITIVE-HD study. American Journal of Kidney Diseases, 74(4), 452–462. https://doi.org/10.1053/j.ajkd.2019.03.424
Vanderlinden, J. A., Ross-White, A., Holden, R., Shamseddin, M. K., Day, A. in Boyd, J. G. (2019). Quantifying cognitive dysfunction across the spectrum of end-stage kidney disease: A systematic review and meta-analysis. Nephrology, 24(1), 5–16. https://doi.org/10.1111/nep.13448
Wu, Z., Zhong, X., Peng, Q., Chen, B., Zhang, M., Zhou, H., Mai, N., Huang, X. in Ning, Y. (2021). Longitudinal association between cognition and depression in patients with late-life depression: A cross-lagged design study. Frontiers in Psychiatry, 12, članek 577058. https://doi.org/10.3389/fpsyt.2021.577058
Zelazo, P. D., Anderson, J. E., Richler, J., Wallner-Allen, K., Beaumont, J. L., Conway, K. P., Gershon, R. in Weintraub, S. (2014). NIH toolbox cognition battery (CB): Validation of executive function measures in adults. Journal of the International Neuropsychological Society, 20(6), 620– 629. https://doi.org/10.1017/S1355617714000472
Zhu, J. J., Chen, Y. J., Chen, L. L., Zhao, L. J. in Zhou, P. (2022). Factors that contribute to the cognitive impairment in elderly dialysis patients. Therapeutic Apheresis and Dialysis, 26(3), 632–639. https://doi.org/10.1111/1744-9987.13740
Zimmermann, P. in Fimm, B. (2021). TAP-M Test of Attentional Performance Mobility Version. PsycTests.
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