Cognitive impairment in kidney transplanted patients
Jolanta Małyszko, Aleksandra Golenia, Michele Farisco, Vincenzina Lo Re, Aleksandra Klimkowicz‐Mrowiec, Giovambattista Capasso, Dimitris Goumenos, Merita Rroji, Andreja Figurek, Gaye Hafez, CONNECT Action (Cognitive Decline in Nephro-Neurology European Cooperative Target) collaborators, Giovambattista Capasso, Alexandre Andrade, Mustafa Arici, Maie Bachmann, Matthew A. Bailey, Michelangela Barbieri, Mickaël Bobot, Annette Bruchfeld, Inga Arune-Bumblyte, Daiva Rastenytė, Antonello Calcutta, Giovanna Capolongo, Sol Carriazo, Michele Ceccarelli, Adrian Covic, Ananya De, Pilar Delgado, Nicole Endlich, Matthias Endres, Fabrizio Esposito, Michele Farisco, Quentin Faucher, Ana Carina Ferreira, Andreja Figurek, Denis Fouque, Casper Franssen, Ivo Fridolin, Sebastian Frische, Liliana Gârneaţă, Loreto Gesualdo, Konstantinos Giannakou, Olivier Godefroy, Aleksandra Golenia, Dimitrios Goumenos, Eugenio Gutiérrez Jiménez, Gaye Hafez, Ewout J. Hoorn, Pedro Henrique Imenez Silva, Raafiah Izhar, Dearbhla Kelly, Shelli R. Kesler, Aleksandra Klimkowicz-Mrowiec, Samuel Knauß, Justina Kurganaite, Hélène Levassort, Sophie Liabeuf, Jolanta Małyszko, Laila-Yasmin Mani, Gianvito Martino, Ziad Massy, Christopher Mayer, Armida Mucci, Alma Mutevelić-Turković, Rikke Nielsen, Dorothea Nitsch, Alberto Ortíz, Vasileios Panagiotopoulos, Despoina Karasavvidou, Giuseppe Paolisso, Bojana Pejušković, Marion Pépin, Alessandra Perna, Andrea Perrottelli, Vesna Pešić, Pasquale Pezzella, Merita Rroji, Ivan Rychlík, Giorgos K. Sakkas, Mariadelina Simeoni, María José Soler Romeo, Goce Spasovski, Ana Starčević, Gioacchino Tedeschi, Francesco Trevisani, Robert Unwin, Evgueniy Vazelov, Carsten A. Wagner, Franca Wagner, Christoph Wanner, Andrzej Więcek, Hong Xu, Miriam Zacchia, Lefteris Zacharia, Irene Zecchino, Carmine Zoccali, Francesco Mattace‐Raso, Karlhans Endlich, Norberto Perico, Giuseppe Remuzzi
Abstract
Chronic kidney disease affects almost all of the organs. Recently, more attention has been paid to the kidney and the central nervous system connections. In patients on kidney replacement therapy, including kidney transplantation, there is an increased prevalence of cognitive impairment, and depression and other neurological complications, such as cerebrovascular disorders and movement disorders. Kidney transplant recipients need an assessment for the risk factors and the pattern of cognitive impairment (memory, attention and executive function decline). This enables an accurate diagnosis to be made at an earlier stage. Partial post-transplant cognitive impairment recovery is also important. Finally, doctors and patients alike face numerous ethical concerns and challenges regarding the transplantation of kidneys and other solid organs. In this review, we examined some key issues regarding cognitive impairment in kidney transplant patients. We focused on the mechanism of cognitive impairment in kidney transplant recipients, patterns of cognitive impairment; evaluation of patients with cognitive impairment for kidney transplantation, the potential impact of cognitive impairment on waitlisted and transplanted patients on patient care, non-pharmacological interventions and unmet medical needs, psychological and ethical issues in kidney transplantation, and unmet needs. As cognitive impairment in kidney transplant recipients is an underestimated, underrecognized but clinically relevant problem, screening for cognitive function before and after kidney transplantation would be worth considering in standard routine practice.