A Study of Executive Function in Patients with Chronic Kidney Disease before and after a Single Session of Hemodialysis

Abstract

Background ?Executive functions (EFs) are critical to daily life and sensitive to our physiological functioning and emotional states. The number of people living with chronic kidney disease (CKD) on hemodialysis (HD) globally is increasing steadily. We aimed to determine the impact of a single session of HD on EFs in patients with CKD receiving maintenance HD (MHD). Methods ?This was a quasi-experimental study conducted at the department of psychiatry and dialysis unit of a tertiary hospital. Patients undergoing MHD underwent screening to rule out delirium, using the Confusion Assessment Method prior to EF testing. The tests of EF used were the Trail-Making Test-Part B (TMT-B) and Frontal Assessment Battery (FAB), both of which were administered before and after a session of HD. Statistical tests used were Wilcoxon matched pairs signed ranks test, paired t -test, single sample t -test, and correlation analyses. Results ?The mean time taken on TMT-B before HD was 195.36 seconds and after HD, 171.1 seconds; difference is significant (p = 0.0001). The mean FAB score was 13.19 before HD and 14.83 after HD; the difference is significant (p < 0.0001). Significant differences were observed on similarities (p = 0.003), lexical fluency (p = 0.02), and go-no go (p = 0.003) subtests of FAB. Mean TMT-B scores before and after HD differed significantly from that of a reference study (reference TMT-B 150.69 seconds), p = 0.0002 and 0.04, respectively. Conclusion ?We conclude that patients with CKD on MHD, in general, have worse executive cognitive functioning compared with healthy populations. A session of HD results in significant improvement in these functions.