Acute kidney injury is associated with subtle but quantifiable neurocognitive impairments
Abstract Background Acute kidney injury (AKI) is associated with long-term morbidity and mortality. The effects of AKI on neurocognitive functioning remain unknown. Our objective was to quantify neurocognitive impairment after an episode of AKI. Methods Survivors of AKI were compared to age-matched controls, as well as a convenience sample of patients matched for cardiovascular risk factors with normal kidney function (active control group). Patients with AKI completed two assessments, while the active control group completed one assessment. The assessment included a standardized test: The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), and a robotic assessment: Kinarm. Results The cohort consisted of 21 patients with AKI, 16 of whom completed both assessments, and 21 active control patients. The majority of patients with AKI had Kidney Disease Improving Global Outcomes stage 3 AKI (86%), 57% received dialysis, and 43% recovered to ≤ 25% of their baseline serum creatinine by their first assessment. Compared to the RBANS, which detected little impairment, the Kinarm categorized patients as impaired in visuomotor (10/21, 48%), attention (10/20, 50%), and executive tasks (11/21, 52%) compared to healthy controls. Additionally, patients with AKI performed significantly worse in attention and visuomotor domains when compared to the active controls. Neurocognitive performance was generally not impacted by the need for dialysis or whether kidney function recovered. Conclusion Robotic technology identified quantifiable neurocognitive impairment in survivors of AKI. Deficits were noted particularly in attention, visuomotor, and executive domains. Further investigation into the downstream health consequences of these neurocognitive impairments is warranted.