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NDT Advance Access originally published online on July 22, 2006
Nephrology Dialysis Transplantation 2006 21(11):3275-3282; doi:10.1093/ndt/gfl385
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© The Author [2006]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Cognitive functioning pre- to post-kidney transplantation—a prospective study

Konstadina Griva1, Derek Thompson2, Dakshina Jayasena2, Andrew Davenport3, Michael Harrison1 and Stanton Peter Newman1

1Centre for Behavioural and Social Sciences in Medicine, University College London, UK, 2Department of Nephrology, Middlesex Hospital, London, UK and 3Department of Nephrology, Royal Free Hospital, London, UK

Correspondence and offprint requests to: Prof. Stanton P. Newman, Centre for Behavioural and Social Sciences in Medicine, Division of Medicine, University College London, Wolfson Building, 48 Riding House Street, London W1N 8AA, UK.Email: s.newman{at}ucl.ac.uk

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.

Conclusion. These data demonstrate improvements in cognition following kidney TX and emphasize the reversibility of the memory problems evidenced in dialysis.

Keywords: cognition; dialysis; neuropsychological; transplantation


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