Abstract
Cognitive impairment in chronic kidney disease (CKD) is commonly associated with neuropsychiatric disorders. As a complex pathology, at all stages of CKD patients need to have a good understanding of the need for drug and nutritional adherence. Cognitive screening is the starting point for detection of cognitive impairments. To determine the specificity and sensitivity of the Brazilian Portuguese version of the Montreal Cognitive Assessment - Basic (MoCA-B) for identification of cognitive impairment in the CKD population. This was a cross-sectional study with 163 CKD patients undergoing hemodialysis treatment. The Mini-Mental State Examination (MMSE) and MoCA-B were administered. The MoCA-B has reliable internal consistency (Cronbach's alpha = 0.74). A cutoff point of ≤ 21 points provides the best sensitivity and specificity for detection of cognitive impairment. The education variable had less impact on the total MoCA-B score than on the total MMSE score. The MoCA-B is a suitable screening instrument for evaluating the global cognition of hemodialysis patients. The results can help health professionals to conduct evaluations and plan clinical management.
Highlights
Cognitive impairment in chronic kidney disease (CKD) is commonly associated with neuropsychiatric disorders
All participants in the sample were at chronic renal disease stage 5, with glomerular filtration rate (GFR) of 15 ml/min or less, and were on hemodialysis
With regard to CKD etiology, the category “others” encompasses patients who had indefinite etiology recorded on their medical records as well as one case of Lupus Nephritis
Summary
Cognitive impairment in chronic kidney disease (CKD) is commonly associated with neuropsychiatric disorders. Cognitive impairment in chronic kidney disease (CKD) is commonly associated with neuropsychiatric disorders such as depression, delirium, and dementia.[1] It is believed that identification of cognitive deficits in chronic patients may have a positive impact on the prognosis of treatment. Intervention can modify the course of the disease,[2] since a patient with cognitive impairment may have poor adherence to medication and treatment, and may have malnutrition, reduced quality of life, increased care costs, and early mortality.[3]. Chronic kidney disease is a complex pathology and so at all stages patients must understand the need for adherence to drug prescriptions and nutritional advice. While no medical intervention currently available can reverse the progression of dementia-related degenerative disorders, it is believed that early identification of cognitive decline may modify the impact of these disorders on cognition and on patient’s lack of autonomy.[2]
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