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Abstract: FR-PO826

Domain Specific Changes in Cognitive Function After Kidney Transplantation

Session Information

Category: Transplantation

  • 2002 Transplantation: Clinical

Authors

  • Gupta, Aditi, University of Kansas Medical Center Department of Internal Medicine, Kansas City, Kansas, United States
  • Lepping, Rebecca J., University of Kansas Medical Center, Kansas City, Kansas, United States
  • Montgomery, Neal, University of Kansas Medical Center, Kansas City, Kansas, United States
  • Sarnak, Mark J., Tufts University, Medford, Massachusetts, United States
  • Burns, Jeffrey M., University of Kansas Medical Center, Kansas City, Kansas, United States
  • Brooks, William M., University of Kansas Medical Center, Kansas City, Kansas, United States
Background

In this largest study assessing cognitive function pre-to post-kidney transplantation (KT) with multiple cognitve tests, we assessed changes in distinct cognitive domains to determine reversibility in cognitive impairment in ESKD.

Methods

We measured cognitive function pre-KT (n=97), 3-months post-KT (n=68), and 1-year post-KT (n=50) and comapred changes using linear mixed model analysis.

Results

Logical Memory IA (fig) and IIA (episodic memory) and Digit symbol substitution (psychomotor speed, visuospatial function) scores were low pre-KT (pre-KT vs. norm: p<0.001 for all) and improved post-KT (pre- vs. post-KT: p<0.001 for Logical Memory IA and IIA, p=0.01 for Digit symbol substitution). Category Fluency (animals) (p<0.001) and Category Fluency (vegetables) (p=0.05) (semantic memory) also improved post-KT. Other cognitive domains did not change with KT (Table).

Conclusion

ESKD is associated with impairments in episodic memory, semantic memory, psychomotor speed, working memory, attention, and visuospatial function. Episodic and semantic memory improve post-KT while cognitive deficits persist in other domains. The differential improvement in cognitive function may reflect differences in underlying mechanisms affecting distinct cognitive domains in ESKD.

Comparisons of Logical Memory IA test scores in pre-KT (Blue circles) and post-KT (Orange diamonds) patients with age matched normative sample from NACC (Black squares).

Comparison of cognitive function in pre-KT, post-KT and normative data using linear mixed effect model, adjusted (for age, cumulative number of neuropsychological testing sessions (practice effects), race, sex and education level).

Funding

  • Other NIH Support