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Risk Factors for Selective Cognitive Decline in Dialyzed Patients with End-Stage Renal Disease: Evidence from Verbal Fluency Analysis

Published online by Cambridge University Press:  17 November 2011

Michał Harciarek ,
John B. Williamson ,
Bogdan Biedunkiewicz ,
Monika Lichodziejewska-Niemierko ,
Alicja Dębska-Ślizień  and
Bolesław Rutkowski
Michał Harciarek*
Affiliation:
Institute of Psychology University of Gdańsk, Gdańsk, Poland Department of Neurology, University of Florida College of Medicine, Gainesville, Florida
John B. Williamson
Affiliation:
Department of Neurology, University of Florida College of Medicine, Gainesville, Florida
Bogdan Biedunkiewicz
Affiliation:
Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdańsk, Gdańsk
Monika Lichodziejewska-Niemierko
Affiliation:
Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdańsk, Gdańsk
Alicja Dębska-Ślizień
Affiliation:
Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdańsk, Gdańsk
Bolesław Rutkowski
Affiliation:
Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdańsk, Gdańsk
*
Correspondence and reprint requests to: Michal Harciarek, Institute of Psychology University of Gdańsk, ul. Bazynskiego 4, 80-952 Gdańsk, Poland. E-mail: mharciarek@yahoo.com
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Abstract

Although dialyzed patients often have cognitive problems, little is known about the nature of these deficits. We hypothesized that, in contrast to semantic fluency relying mainly on temporal lobes, phonemic fluency, preferentially depending on functions of frontal-subcortical systems, would be particularly sensitive to the constellation of physiological pathological processes associated with end-stage renal disease and dialysis. Therefore, we longitudinally compared phonemic and semantic fluency performance between 49 dialyzed patients and 30 controls. Overall, patients performed below controls only on the phonemic fluency task. Furthermore, their performance on this task declined over time, whereas there was no change in semantic fluency. Moreover, this decline was related to the presence of hypertension and higher blood urea nitrogen. We suggest that these findings may be due to a combination of vascular and topic effects that impact more on fronto-subcortical than temporal lobe networks, but this speculation requires direct confirmation. (JINS, 2012, 18, 162–167)

Keywords

End-stage renal diseaseDialysisPhonemic fluencySemantic fluencyHypertensionNeurotoxicity
Type
Brief Communications
Information
Journal of the International Neuropsychological Society , Volume 18 , Issue 1 , January 2012 , pp. 162 - 167
Copyright
Copyright © The International Neuropsychological Society 2011

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