Journal of Behavioral Medicine

, Volume 6, Issue 3, pp 291–311 | Cite as

Effects of hemodialysis on the cognitive and sensory-motor functioning of the adult chronic hemodialysis patient

  • Dennis Paul Ratner
  • Kenneth M. Adams
  • Nathan W. Levin
  • Byron P. Rourke
Article

Abstract

Twenty chronically dialyzed adults were administered a repeatable battery of 14 cognitive and sensory-motor tests on 3 consecutive days: immediately prior to their midweek dialysis, approximately 20 hr after their midweek dialysis, and again immediately prior to their end-of-the week dialysis. Serum electrolyte and methylamine analyses were performed at each test session. When compared to established norms, these patients scored within the normal range in a wide variety of areas. Limited impairments, probably due to peripheral neuropathy, were in evidence on the Grooved Pegboard, Finger Tapping (females), and Grip Strength (females) measures. Impairments suggestive of cerebral dysfunction were also noted on the Benton Visual Retention Test and on the Trail Making Test, Parts A and B, with particularly severe impairment noted on Part B. Despite significant daily changes in serum levels of toxic substances retained in uremia, there was little or no evidence to suggest that well-dialyzed patients undergo daily fluctuations in their cognitive and sensory-motor functioning.

Key words

cognition hemodialysis neuropsychology sensory-motor function 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Abrams, H. S. (1969). The psychiatrist, the treatment of chronic renal failure, and the prolongation of life.II. Am. J. Psychiat. 126: 157–167.Google Scholar
  2. Adams, K. M., Rennick, P. M., Schoof, K. G., and Keegan, J. F., (1975). Neuropsychological measurement of drug effects: Polydrug research.J. Psychedel. Drugs 2; 151–160.Google Scholar
  3. Adams, K. M., Sawyer, J. D., and Kvale, P. A. (1980). Cerebral oxygenation and neuropsychological adaptation.J. Clin. Neuropsychol. 2: 189–208.Google Scholar
  4. Ammons, R. G., and Ammons, C. H. (1962).The Quick-Test (QT): Provisional Manual, Psychological Test Specialists, Missoula, Mont.Google Scholar
  5. Benton, A. L. (1963). TheRevised Visual Retention Test, The Psychological Corporation, New York.Google Scholar
  6. Blatt, B., and Tsushima, W. T. (1966). A psychological survey of uremic patients being considered for the chronic hemodialysis program: Intellectual and emotional patterns in uremic patients.Nephron 3: 206–208.Google Scholar
  7. Dunn, S. R., Simenhoff, M. L., and Wesson, L. G. (1976). Gas chromatograph determination of free mono-, di-, and trimethylamines in biological fluids.Anal. Chem. 48: 41–43.Google Scholar
  8. Fishman, R., and Raskin, N. (1967). Experimental uremic encephalopathy.Arch. Neurol. 17: 10–21.Google Scholar
  9. Friedman, E. (1978).The uremic syndrome. In Friedman, E. (ed.),Strategies in Renal Failure, Wiley, New York.Google Scholar
  10. Ginn, H. E. (1973). Neurobehavioral and clinical responses to hemodialysis.Proceedings of the Sixth Annual Contractors Conference, DHEW Pub. (NIH) 74-248, Bethesda, Md.Google Scholar
  11. Ginn, H. E. (1975). Neurobehavioral dysfunction in uremia.Kidney Int. Suppl. 2: 217–221.Google Scholar
  12. Ginn, H. E., Teschan, P. E., Walker, P. J., Bourn, J. R., Fristoe, M., Ward, J. W., McLain, L. W., Johnston, H. B., and Hamel, B. (1975). Neurotoxicity in uremia.Kidney Int. Suppl. 3: 357–360.Google Scholar
  13. Gorham, D. R. (1956). The Proverbs Test for clinical and experimental use.Psychol. Rep. 2: 1–12.Google Scholar
  14. Greenberg, R. P., Davis, D., and Massey, R. (1973). The psychological evaluation of patients for a kidney transplant and hemodialysis program.Am. J. Psychiat. 130: 274–277.Google Scholar
  15. Hagberg, B. (1974). A prospective study of patients in chronic hemodialysis. III.J. Psychosom. Res. 18: 151–160.Google Scholar
  16. McDaniel, J. W. (1971). Metabolic and CNS correlates of cognitive dysfunction with renal failure.Psychophysiology 704–713.Google Scholar
  17. Murawski, B. J. (1970). A measure of sustained attention in human uremics. In Bluemle, L. W., Colletti, R. B., and Krueger, K. K. (eds.),Workshop on Behavioral Bioassays in Uremia, National Institutes of Health, Bethesda, Md.Google Scholar
  18. Murawski, B. J., Spector, E. L., and Follette, W. (1973). Elucidation of the toxic nature of uremia.Proceedings of the Sixth Anual Contractors Conference, DHEW Pub. (N. I. M.) 74-248, Bethesda, Md.Google Scholar
  19. National Institutes of Health (1978).Manual for The Cooperative Dialysis Study, NIHNIAMDD, Contract NIH-NIAMDD NOI AM 6-2207, Washington, D.C.Google Scholar
  20. Raskin, N. H., and Fishman, R. A. (1976). Neurological aspects of renal failure. In Brenner, B. M., and Rector, F. C. (eds.),The Kidney, Vol. II, Saunders, Philadelphia.Google Scholar
  21. Reitan, R. M. (1969).Manual for Administration of Neuropsychological Test Batteries for Adults and Children, University of Washington Neuropsychology Laboratory, Seattle.Google Scholar
  22. Reitan, R. M., and Davidson, L. (eds.) (1974).Clinical Neuropsychology: Current Status and Applications, Halstead, New York.Google Scholar
  23. Rennick, P. M. (1974).Procedures for Repeatable-Cognitive-Perceptual-Motor Testing and General Neuropsychological Assessment, Lafayette Clinic, Detroit.Google Scholar
  24. Sand, P., Livingston, G., and Wright, R. G. (1966). Psychological assessment of candidates for a hemodialysis program.Ann. Intern. Med. 64: 602–610.Google Scholar
  25. Sharp, J., and Murphy, C. (1964). Conditioned avoidance behavior in primates during various experimental uremic states.Nephron 1: 172–179.Google Scholar
  26. Simenhoff, M. L., Ginn, H. E., and Teschan, P. E. (1977). Toxicity of aliphatic amines in uremia.Trans. Am. Soc. Art. Organs 23: 560–564.Google Scholar
  27. Spehr, W., Satorius, H., Berglund, K., Hjorth, B., Kablitz, C., Plog, U., Wiedeman, P. H., and Zapf, K. (1977). EEG and hemodialysis. A structural survey of EEG spectral analysis. Hijorth's EEG descriptions blood variables and psychological data.Electroenceph. Clin. Neurophysio. 43: 787–797.Google Scholar
  28. Teschan, P. E., Ginn, H. E., Walker, P. J., Bourne, J. E., Fristoe, M., and Ward, J. W. (1974). Quantified functions of the nervous system in uremic patients on maintenance hemodialysis.Trans. Am. Soc. Art. Intern. Organs 20A: 338–392.Google Scholar
  29. Thurstone, L. L. (1938).Primary Mental Abilities, University of Chicago Press, Chicago.Google Scholar
  30. Trieschmann, R. B., and Sand, B. (1971). WAIS and MMPI correlates of increasing renal failure in adult medical patients.Psychol. Rep. 20: 1251–1262.Google Scholar
  31. Wechsler, D. (1955).Manual for the Wechsler Adult Intelligence Scale, Psychological Corporation, New York.Google Scholar

Copyright information

© Plenum Publishing Corporation 1983

Authors and Affiliations

  • Dennis Paul Ratner
    • 1
  • Kenneth M. Adams
    • 2
  • Nathan W. Levin
    • 2
  • Byron P. Rourke
    • 3
  1. 1.Kennebec Valley Mental Health CenterWaterville
  2. 2.Divisions of Neuropsychology and NephrologyHenry Ford HospitalDetroit
  3. 3.University of Windsor and Windsor Western Hospital CentreWindsorCanada

Personalised recommendations