F. H. F. CHAN1, Z. Z. S. GOH1, B. A. KHAN2, S. HAROON3, T. LAU3, K. GRIVA1
Nanyang Technological University1, National Kidney Foundation, Singapore2, National University Hospital3
Cognitive impairments in end-stage renal disease (ESRD) may interfere with patients’ treatment adherence and self-management abilities and are associated with adverse outcomes including higher hospitalisation and mortality risks. Although the cognitive burden of ESRD is well-established, most prior work focused on objective cognitive function, whereas subjective cognitive complaints (SCCs) have often been neglected. This study aimed to review (1) available measures of SCCs in ESRD patients, (2) the magnitude of SCCs in ESRD patients, and (3) differences in SCCs between treatment modalities.
The systematic review was registered within the PROSPERO database and undertaken in accordance with PRISMA guidelines. MEDLINE, Embase, Web of Science Core Collection, PsycINFO, and CINAHL were searched (inception to 2021). Studies were included if they (1) involved adult patients with ESRD and (2) reported at least one outcome measure of SCCs.
Two-hundred-and-twenty-two studies were relevant, with the majority on dialysis patients (85%) and some on pre-dialysis and transplantation patients. Ten measures of SCCs were identified, with the Kidney Disease Quality of Life-Cognitive Function subscale being the mostly frequently used measure. The magnitude of SCCs varied widely across studies. There was no significant difference in SCCs between haemodialysis and peritoneal dialysis patients. Findings regarding other treatment modalities such as home haemodialysis, nocturnal haemodialysis, and kidney transplantation, have been mixed.
More work is needed to map SCCs across renal replacement modalities, their associations with other outcomes and to identify critical cut offs to guide optimisation and refinement of existing services related to cognitive rehabilitation.