Neurocognitive Disorders in Chronic Kidney Disease: A Case Report and Literature Review

Abstract

Chronic kidney disease (CKD) is a substantial public health problem. In the United States, almost 8% of the population has CKD and 571,000 patients receive treatment for endstage renal disease. Although the incidence of CKD is increasing in all age groups, this is particularly true in the elderly. There is a greater risk of developing neurocognitive disorders and dementia in older adults, and amajor determinant of quality of life in the elderly is the level of cognitive function. Recent data in this regard suggest that in individuals at all stages of CKD, theremay be a higher risk of developing dementia and cognitive impairment than in those without CKD. Given the increase in life expectancy and the aging of the population in industrialized countries, the neurocognitive disorder burden associated with CKD is expected to worsen. Up to 70% of patients undergoing hemodialysis who are 55 years and older have moderate to severe chronic cognitive impairment, yet it is largely undiagnosed. Dementia is associated with high risks of death, dialysis withdrawal, hospitalization, and disability among patients with endstage renal disease. We describe the case of Ms. A, who is undergoing hemodialysis, in whom various neuropsychiatric symptoms developed, and we review the relevant literature on neurocognitive disorders in CKD. University, Saga, Japan (HT, TH, JM, YH, YM, TK, AM); Department of Radiology, Faculty of Medicine, Saga University, Saga, Japan (TN); Department of Neuropsychiatry, Graduate School of Medical Sciences, Fukuoka, Japan (TAK). Send correspondence and reprint requests to Hiroshi Tateishi, M.D., and Akira Monji, M.D., Address: 5-1-1 Nabeshima, Saga, Japan; e-mail: muutoyukainanakamatachi@gmail.com, amonji@hf.rim.or.jp & 2016 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved. Case Report