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Meta-analysis of cognitive functioning in patients following kidney transplantation

Joshee, Paras, Wood, Amanda G., Wood, Eleri R. and Grunfeld, Elizabeth A. 2018, Meta-analysis of cognitive functioning in patients following kidney transplantation, Nephrology dialysis transplantation, vol. 33, no. 7, pp. 1268-1277, doi: 10.1093/ndt/gfx240.

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Title Meta-analysis of cognitive functioning in patients following kidney transplantation
Author(s) Joshee, Paras
Wood, Amanda G.ORCID iD for Wood, Amanda G. orcid.org/0000-0002-1537-6858
Wood, Eleri R.
Grunfeld, Elizabeth A.
Journal name Nephrology dialysis transplantation
Volume number 33
Issue number 7
Start page 1268
End page 1277
Total pages 10
Publisher Oxford University Press
Place of publication Oxford, Eng.
Publication date 2018-07
ISSN 0931-0509
1460-2385
Keyword(s) Science & Technology
Life Sciences & Biomedicine
Transplantation
Urology & Nephrology
chronic kidney disease
cognition
dialysis
kidney transplant
systematic review
REVERSIBLE ENCEPHALOPATHY SYNDROME
QUALITY-OF-LIFE
RENAL-TRANSPLANTATION
DISEASE
DEPRESSION
HEMODIALYSIS
IMPAIRMENT
RECIPIENTS
THERAPY
Summary © 2018 The Author(s). Background. There is mixed evidence regarding the nature of cognitive function in patients who have undergone renal transplantation. The aim of this meta-analysis was to examine which cognitive domains are impacted following kidney transplantation and how performance compares with non-transplanted patients or healthy controls/normative data. Method. A systematic search was conducted using keywords within three databases (Embase, MEDLINE and PsychINFO), yielding 458 unique studies, 10 of which met the inclusion criteria. Neuropsychological tests were grouped into nine cognitive domains and three separate analyses were undertaken within each domain: (i) within subjects pre-versus post-transplant, (ii) transplanted versus non-transplanted patients and (iii) transplanted versus healthy matched controls and standardized normative data. Results. Transplanted patients showed moderate to large improvements in the domains of general cognitive status (g = 0.526), information and motor speed (g = 0.558), spatial reasoning (g = 0.376), verbal memory (g = 0.759) and visual memory (g = 0.690) when compared with their pre-operative scores. Test scores in the same five domains were significantly better in post-transplanted patients when compared with dialysis-dependant or conservatively managed chronic kidney disease patients. However, post-transplanted patients' performance was significantly low compared with that of healthy controls (and standardized normative data) in the domains of executive functioning (g =-0.283), verbal fluency (g =-0.657) and language (g =-0.573). Conclusions. Two key issues arise from this review. First, domain-specific cognitive improvement occurs in patients after successful transplantation. Nevertheless, transplanted patients still performed significantly below healthy controls in some domains. Second, there are important shortcomings in existing studies; the length of follow-up is typically short and only limited neuropsychological test batteries are employed. These factors are important in order to support the recovery of cognitive function among patients following renal transplant.
Language eng
DOI 10.1093/ndt/gfx240
Indigenous content off
Field of Research 1103 Clinical Sciences
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2018, The Authors
Free to Read? Yes
Persistent URL http://hdl.handle.net/10536/DRO/DU:30128623

Document type: Journal Article
Collections: Faculty of Health
School of Psychology
Open Access Collection
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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.