Evaluation of cerebral dysfunction in patients with chronic kidney disease using neuropsychometric and neurophysiological tests
Background Uremic encephalopathy is defined as cerebral dysfunction due to toxin accumulation in patients with chronic kidney disease (CKD). This condition is characterized by subtle to florid symptoms, and its clinical course is always progressive when untreated but partially reversible with renal...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2021-01-01
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| Series: | Renal Failure |
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| Online Access: | http://dx.doi.org/10.1080/0886022X.2021.1901740 |
| _version_ | 1798031756018843648 |
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| author | Fabiola Sanchez-Meza Aldo Torre Lilia Castillo-Martinez Sofia Sanchez-Roman Luis Eduardo Morales-Buenrostro |
| author_facet | Fabiola Sanchez-Meza Aldo Torre Lilia Castillo-Martinez Sofia Sanchez-Roman Luis Eduardo Morales-Buenrostro |
| author_sort | Fabiola Sanchez-Meza |
| collection | DOAJ |
| description | Background Uremic encephalopathy is defined as cerebral dysfunction due to toxin accumulation in patients with chronic kidney disease (CKD). This condition is characterized by subtle to florid symptoms, and its clinical course is always progressive when untreated but partially reversible with renal replacement therapy. While no test exists to measure subclinical uremic encephalopathy, two tests have been validated to measure minimal hepatic encephalopathy: the critical flicker frequency (CFF) test and the psychometric hepatic encephalopathy score (PHES). Objective To use CFF and PHES to measure the prevalence of cerebral dysfunction in individuals with CKD. Methods This cross-sectional study included a total of 69 patients with stage-5 CKD. Cutoff points for minimal encephalopathy were established using existing clinical guidelines: ≤39 Hz for CFF and < −4 for PHES. All participants were also screened for cognitive function and depression. Results Eighteen cases (26.1%) of cerebral dysfunction linked to uremic encephalopathy were detected with CFF, while twelve (17.4%) were detected by PHES; only six cases (8.7%) were diagnosed by both methods. Half of the cases (50%) had diabetes, and 61% were on hemodialysis. Cognitive function scores did not differ significantly between those receiving dialysis, hemodialysis, or no renal replacement therapy. Conclusions It is essential to identify cerebral dysfunction when uremic encephalopathy is in early subclinical stages to reduce preventable events as traffic and work accidents. |
| first_indexed | 2024-04-11T20:02:42Z |
| format | Article |
| id | doaj.art-9d1d916be2ec448c8423619124a57cf3 |
| institution | Directory Open Access Journal |
| issn | 0886-022X 1525-6049 |
| language | English |
| last_indexed | 2024-04-11T20:02:42Z |
| publishDate | 2021-01-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Renal Failure |
| spelling | doaj.art-9d1d916be2ec448c8423619124a57cf32022-12-22T04:05:32ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492021-01-0143157758410.1080/0886022X.2021.19017401901740Evaluation of cerebral dysfunction in patients with chronic kidney disease using neuropsychometric and neurophysiological testsFabiola Sanchez-Meza0Aldo Torre1Lilia Castillo-Martinez2Sofia Sanchez-Roman3Luis Eduardo Morales-Buenrostro4Department of Nephrology and Mineral Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán”Liver Unit, Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán”Department of Clinical Nutrition, Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán”Neurology and Psychiatry Department, Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán”Department of Nephrology and Mineral Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán”Background Uremic encephalopathy is defined as cerebral dysfunction due to toxin accumulation in patients with chronic kidney disease (CKD). This condition is characterized by subtle to florid symptoms, and its clinical course is always progressive when untreated but partially reversible with renal replacement therapy. While no test exists to measure subclinical uremic encephalopathy, two tests have been validated to measure minimal hepatic encephalopathy: the critical flicker frequency (CFF) test and the psychometric hepatic encephalopathy score (PHES). Objective To use CFF and PHES to measure the prevalence of cerebral dysfunction in individuals with CKD. Methods This cross-sectional study included a total of 69 patients with stage-5 CKD. Cutoff points for minimal encephalopathy were established using existing clinical guidelines: ≤39 Hz for CFF and < −4 for PHES. All participants were also screened for cognitive function and depression. Results Eighteen cases (26.1%) of cerebral dysfunction linked to uremic encephalopathy were detected with CFF, while twelve (17.4%) were detected by PHES; only six cases (8.7%) were diagnosed by both methods. Half of the cases (50%) had diabetes, and 61% were on hemodialysis. Cognitive function scores did not differ significantly between those receiving dialysis, hemodialysis, or no renal replacement therapy. Conclusions It is essential to identify cerebral dysfunction when uremic encephalopathy is in early subclinical stages to reduce preventable events as traffic and work accidents.http://dx.doi.org/10.1080/0886022X.2021.1901740critical flicker frequencychronic kidney failureuremic encephalopathycerebral dysfunctionuremia |
| spellingShingle | Fabiola Sanchez-Meza Aldo Torre Lilia Castillo-Martinez Sofia Sanchez-Roman Luis Eduardo Morales-Buenrostro Evaluation of cerebral dysfunction in patients with chronic kidney disease using neuropsychometric and neurophysiological tests Renal Failure critical flicker frequency chronic kidney failure uremic encephalopathy cerebral dysfunction uremia |
| title | Evaluation of cerebral dysfunction in patients with chronic kidney disease using neuropsychometric and neurophysiological tests |
| title_full | Evaluation of cerebral dysfunction in patients with chronic kidney disease using neuropsychometric and neurophysiological tests |
| title_fullStr | Evaluation of cerebral dysfunction in patients with chronic kidney disease using neuropsychometric and neurophysiological tests |
| title_full_unstemmed | Evaluation of cerebral dysfunction in patients with chronic kidney disease using neuropsychometric and neurophysiological tests |
| title_short | Evaluation of cerebral dysfunction in patients with chronic kidney disease using neuropsychometric and neurophysiological tests |
| title_sort | evaluation of cerebral dysfunction in patients with chronic kidney disease using neuropsychometric and neurophysiological tests |
| topic | critical flicker frequency chronic kidney failure uremic encephalopathy cerebral dysfunction uremia |
| url | http://dx.doi.org/10.1080/0886022X.2021.1901740 |
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