Cognitive decline related to chronic kidney disease as an exclusion factor from kidney transplantation: results from an international survey.

Autor: Farisco M; Department of Public Health and Caring Sciences, Centre for Research Ethics and Bioethics, Uppsala University, Uppsala, Sweden.; Biogem Molecular Biology and Genetics Research Institute, Ariano Irpino (AV), Italy., Blumblyte IA; Department of Nephrology, Lithuanian University of Health Sciences, Kaunas, Lithuania., Franssen C; Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands., Nitsch D; UK Renal Registry, UK Kidney Association, Bristol, UK.; Department of Non-communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.; Department of Nephrology, Royal Free London NHS Foundation Trust, London, UK., Zecchino I; Department of Science and Technology, University of Sannio, Benevento, Italy., Capasso G; Department of Public Health and Caring Sciences, Centre for Research Ethics and Bioethics, Uppsala University, Uppsala, Sweden.; Department Translational Medical Science, University Campania Luigi Vanvitelli, Naples, Italy., Hafez G; Department of Pharmacology, Faculty of Pharmacy, Altinbas University, Istanbul, Turkey.
Jazyk: angličtina
Zdroj: Clinical kidney journal [Clin Kidney J] 2024 Apr 13; Vol. 17 (5), pp. sfae114. Date of Electronic Publication: 2024 Apr 13 (Print Publication: 2024).
DOI: 10.1093/ckj/sfae114
Abstrakt: Background and Hypothesis: There seems to be a lack of consensus on the necessity and the modality of psychological and specifically cognitive assessment of candidates for kidney transplantation. Both points are often delegated to individual hospitals/centres, whereas international guidelines are inconsistent. We think it is essential to investigate professionals' opinions to advance towards a consistent clinical practice.
Methods: This paper presents the results of an international survey among clinical professionals, mainly nephrologists from the CONNECT (Cognitive decline in Nephro-Neurology: European Cooperative Target) network and beyond (i.e. from personal contacts of CONNECT members). The survey investigated their opinions about the question of whether cognitive decline in patients with chronic kidney disease may affect their eligibility for kidney transplantation.
Results: Our results show that most clinicians working with patients affected by chronic kidney disease think that cognitive decline may challenge their eligibility for transplantation despite data that suggest that, in some patients, cognitive problems improve after kidney transplantation.
Conclusion: We conclude that three needs emerge as particularly pressing: defining agreed-on standards for a multifaceted and multifactorial assessment (i.e. including both clinical/medical and psychosocial factors) of candidates with chronic kidney disease to kidney transplantation; further investigating empirically the causal connection between chronic kidney disease and cognition; and further investigating empirically the possible partial reversibility of cognitive decline after kidney transplantation.
Competing Interests: None declared.
(© The Author(s) 2024. Published by Oxford University Press on behalf of the ERA.)
Databáze: MEDLINE
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