Introduction:
There is an increased risk of cognitive impairment with end stage kidney failure (ESKF) which leads to poor quality of life and increased mortality. This study had as an aim to evaluate the magnitude of cognitive impairment in patients undergoing maintenance haemodialysis (MHD) in 2 referral hospitals in Cameroon.
Methods:
This was a cross sectional study at the Bamenda Regional and Yaounde General Hospitals over a period of four months (January 1rst to April 30th 2023) including consenting MHD patients aged ≥ 18 years. Those with history of stroke, psychiatric disorders or epilepsy were excluded. We reviewed medical reports and screened for cognitive impairment using Montreal cognitive assessment test version 8.3 (MoCA) in all consenting patients on MH. Cognitive impairment was considered for a Montreal Cognitive Assessment tool score (MoCA score) <26 and be classified as mild (MoCA 18-25), moderate (MoCA 10-17) or severe (MoCA<10). Data were analyzed with international business machine statistical package for social sciences (IBM-SPSS). The confidence interval (CI) was set at 95% and a significant value of p<0.05. Ethical considerations were respected.
Results:
A total of 180 participants (56.1% male, mean age 45.9 ± 13.5 years) were included. Hypertension (87.2%), diabetes (18.3%) and HIV (6.7%) were the most common comorbidities. The median MHD vintage was 32.44 [15.4 – 66.7] months. The prevalence of cognitive impairment was 68.9% (n=124) with respectively 58.9% and 10% who had mild and moderate impairment and no participant with severe impairment. The main cognitive domains affected were memory, attention and orientation. Low level of education (p=0.000), female gender (p=0.033, CI:1.054-3.963) and rural residence (p=0.017, CI:1.170-23.045) were associated with cognitive impairment.
Conclusions:
The prevalence of cognitive impairment was high in MHD with specific domains affected suggestive for vascular-related mecanism. The benefits of high blood pressure treatment are well established. The impact of neurological stimulation exercises during dialysis sessions would be important to evaluate.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.