Kidney failure is believed to have a negative impact on cognitive function,
and cognitive impairment is common in people with chronic kidney disease and end -
stage kidney disease (ESKD). Diagnosis of cognitive impairment in this population of
patients is important because cognitive impairment may have a role in the patient’s
understanding and acceptance of ESKD care, both at the initiation and duration of
kidney replacement therapy. The pathophysiology of cognitive impairment is uncertain;
it is a complex and probably multifactorial process. It is not known whether cognitive
impairment is mediated by direct toxic effects of uraemia per se, or is attributed to a
high prevalence of predisposing risk factors among ESKD patients and side effects of
dialysis treatment. Recent studies noted that cognitive impairment in patients with end
stage renal disease is likely to improve with successful kidney transplantation and that
early beneficial effects of kidney transplantation on cognitive function are not transient
and were still evident one year following successful kidney transplantation.On the other
hand, some cognitive limitations may still be present in kidney transplant recipients and
cognitive impairment in kidney transplant recipients may impact decision-making as
well the ability to adhere to transplantation recommendations, such as dietary
modification and complex medication compliance. Delay in diagnosis and treatment of
cognitive impairment may result in medication non adherence and subsequent severe
adverse effects such as acute graft rejection. Periodic assessment of end stage renal
disease patient’s cognitive function prior and post transplantation should be one of the
parameters to be considered on evaluating outcomes after kidney transplantation.
Keywords: Cognitive function, kidney tran splantation, end - stage kidney
disease, kidney failure, cognitive impairment, kidney replacement therapy,
adherence, compliance, medical regimen, hemodialysis.
