Abstract
Abstract Background and Aims Cognitive impairment is common in patients with End Stage Kidney Disease. There are conflicting reports regarding the degree and interval of improvement of cognitive functions with the different modalities of renal replacement therapy. Most of the published reports relied on screening tests not covering the emotional aspects of cognition. Also, the timings of assessment are different being at most during the first year of establishing the modality. Method Ninety age, gender, and educational level-matched participants were enrolled in the study. The participants were divided into three equal groups, thirty kidney transplant (KT) patients, thirty hemodialysis patients (HD) for more than two years, and thirty control non-diseased participants. The participants included were below 60 years of age and with no previous history of a neurological defect. All patients were subjected to three Computerized Neurocognitive Battery tests (Age differentiation test, emotional recognition, and differentiation). All the tests were judged for accuracy and the time consumed to answer. Results The median value of transplant duration was 59 months (24- 168), and 66 months (27- 180) of HD duration. Both groups were comparable in age, gender, educational level, socioeconomic, and marital status. KT patients were comparable to controls at all parameters of testing. KT patients' answers were significant of higher accuracy than HD patients (P = 0.04 for age differentiation and emotion recognition, and 0.005 for emotion differentiation). KT and HD had comparable response times. Total correct responses of emotional differentiation tests were negatively correlated with KT duration (rho = −0.348, P = 0.02), and (rho = −0.345, P = 0.01) for HD duration. The cumulative steroid dose was not correlated with any of the tested parameters in the KT group. Conclusion KT offers a much better emotional and social cognitive improvement, an effect that is expected to positively impact the quality of life and involvement in society.
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