Cognitive function of individuals with end-stage renal disease on hemodialysis

Abstract

An interrupted time series with non-equivalent dependent variables design was used to determine if there is a difference in attention and memory of adults on hemodialysis immediately before, during, and after a dialysis treatment. The study also investigated if BUN, creatinine, and carbon dioxide were predictive of cognitive function. The study sample included 52 individuals with a mean age of 45.5 years on out-patient dialysis an average of 10.6 months. The sample was 52% male; 73% of the subjects were Black, 19% were white, and 6% were Hispanic. Subjects completed two tests of attention - Trailmaking Test A and B and one memory test - the Auditory Verbal Learning Test. The tests were adm.inistered immediately before, 60-90 minutes after the beginning, and immediately after a HD treatment session. Blood for BUN, Creatinine, and carbon dioxide were obtained within 5 minutes of the cognitive function testing. Testing times were separated by one week. Cognitive function test results were analyzed using Repeated Measures Analysis of Variance. Analysis revealed that there were no significant differences (p>.05) in attention or memory among the three testing times. Despite significant differences (p<.05) in BUN, creatinine, and carbon dioxide among the three testing times, there was no significant correlation between serum values and cognitive function test results. Additional findings revealed that when compared to normal reference values, subjects had significantly (p<.05) impaired attention and memory function at all three testing times. Although memory function was impaired, a pattern that indicated information retention was demonstrated. The lack of difference in attention and memory function among the three testing times indicated that attention and memory did not vary during a dialysis treatment session. Therefore, the current practice of teaching patients throughout the dialysis session was supported. The pattern of memory function demonstrated in the sample supports the assertion in the theoretical literature that repetition of information plays an important role in teaching patients on dialysis.