scholarly journals Montreal Cognitive Assessment for cognitive assessment in chronic kidney disease: a systematic review

2019 ◽  
Vol 41 (1) ◽  
pp. 112-123 ◽  
Author(s):  
Thaís Malucelli Amatneeks ◽  
Amer Cavalheiro Hamdan
Keyword(s):  
Systematic Review ◽  
Chronic Kidney Disease ◽  
Cognitive Impairment ◽  
Kidney Disease ◽  
Cognitive Assessment ◽  
Montreal Cognitive Assessment ◽  
Treatment Modalities ◽  
Cross Sectional ◽  
Application Profile ◽  
Made In

Abstract Introduction: There is evidence in the literature that cognitive impairment is more prevalent in individuals with chronic kidney disease (CKD) than in the general population. The Montreal Cognitive Assessment (MoCA) is an instrument with a good application profile for cognitive evaluation of patients with CKD-like impairments. The objective of this study is to perform a systematic review of MoCA use in the context of CKD. Method: The keywords "Montreal Cognitive Assessment", "Kidney Disease" and "Chronic Kidney Disease" were used to search the databases. The inclusion criteria were: a) empirical articles; b) approach to cognitive impairment in CKD; c) papers in Portuguese and English. Results: The studies were mostly cross-sectional, published in medical journals, with research carried out mostly in Europe. About 45% of the studies had samples of less than 150 participants and variations in the prevalence of cognitive impairment were found ranging from 28.9% to 74.6%. The cutoff point for the identification of the impairment presented variation between the studies. Discussion: The results' analysis demonstrates the need for more complete studies on MoCA scoring and adaptation in its different versions. We recommend to the health professionals who will use the results in the clinical setting that the interpretation of the results be made in the light of studies more related to the context lived by the patients. Conclusions: The instrument is efficient to be used in several stages and treatment modalities of the disease. We point to the need to adapt a cut-off point for the instrument in the different translations of the instrument.

scholarly journals Sensitivity and specificity of the Brazilian version of the Montreal Cognitive Assessment – Basic (MoCA-B) in chronic kidney disease

2019 ◽  
Vol 41 (4) ◽  
pp. 327-333
Author(s):  
Thaís Malucelli Amatneeks ◽  
Amer Cavalheiro Hamdan
Keyword(s):  
Chronic Kidney Disease ◽  
Cognitive Impairment ◽  
Kidney Disease ◽  
Sensitivity And Specificity ◽  
Cognitive Assessment ◽  
Montreal Cognitive Assessment ◽  
Cognitive Screening ◽  
Cross Sectional ◽  
Specificity And Sensitivity ◽  
Starting Point

Abstract Introduction Cognitive impairment in chronic kidney disease (CKD) is commonly associated with neuropsychiatric disorders. As a complex pathology, at all stages of CKD patients need to have a good understanding of the need for drug and nutritional adherence. Cognitive screening is the starting point for detection of cognitive impairments. Objective To determine the specificity and sensitivity of the Brazilian Portuguese version of the Montreal Cognitive Assessment – Basic (MoCA-B) for identification of cognitive impairment in the CKD population. Methods This was a cross-sectional study with 163 CKD patients undergoing hemodialysis treatment. The Mini-Mental State Examination (MMSE) and MoCA-B were administered. Results The MoCA-B has reliable internal consistency (Cronbach’s alpha = 0.74). A cutoff point of ≤ 21 points provides the best sensitivity and specificity for detection of cognitive impairment. The education variable had less impact on the total MoCA-B score than on the total MMSE score. Conclusions The MoCA-B is a suitable screening instrument for evaluating the global cognition of hemodialysis patients. The results can help health professionals to conduct evaluations and plan clinical management.

scholarly journals Montreal Cognitive Assessment (MoCA) screening mild cognitive impairment in patients with chronic kidney disease (CKD) pre-dialysis

2016 ◽  
Vol 38 (1) ◽  
Author(s):  
Marilise de Andrade Paraizo ◽  
Ana Laura Maciel Almeida ◽  
Leopoldo Antônio Pires ◽  
Renata Silva Almeida Abrita ◽  
Mary Hellen Teixeira Crivellari ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Kidney Disease ◽  
Cognitive Assessment ◽  
Montreal Cognitive Assessment

Abstract P116: Chronic Kidney Disease And Cardiac Arrhythmias: A Systematic Review and Meta-analysis

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Esther D Kim ◽  
Ning Ding ◽  
Junichi Ishigami ◽  
Xuejuan Ning ◽  
Yijing Feng ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Systematic Review ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Prospective Studies ◽  
Cardiac Arrhythmias ◽  
Meta Analysis ◽  
Case Control ◽  
Cross Sectional ◽  
The Relationship

Background: Chronic kidney disease (CKD) strongly predicts sudden cardiac death and may elevate the risk of certain cardiac arrhythmias like atrial fibrillation; however, the relationships between CKD and various types of arrhythmia are not well-characterized. Methods: We performed a systematic review and meta-analysis by searching Embase and PubMed for prospective, cross-sectional, and case-control studies examining the associations of two key CKD measures, estimated glomerular filtration rate (eGFR) and albuminuria, with arrhythmias in adults that were published until July 2018. We performed qualitative assessment of studies using the Newcastle Ottawa Quality Assessment Scale. We pooled the results using random-effects models. Results: Among 16,245 articles, we identified 34 prospective (n=24,213,233), 21 cross-sectional (n=253,328), and 4 case-control (n=1,694) studies that included diverse study populations from 19 countries and were mostly high quality. Most prospective studies examined the relationship between eGFR and atrial fibrillation (AF), and demonstrated that lower eGFR was associated with a higher risk of AF (pooled hazard ratio [HR] 1.72 [95% CI: 1.30, 2.27] comparing reduced vs. referent eGFR groups)[ Figure ]. A few studies examined albuminuria and demonstrated its associations with AF (pooled HR 2.16 [95% CI: 1.74, 2.67] comparing high vs. low albuminuria). Results were similar for cross-sectional studies. Four prospective studies reported a higher incidence of ventricular tachycardia resulting in ICD shock according to reduced eGFR (pooled HR 2.32 [95% CI: 1.74, 3.09] comparing reduced vs. referent eGFR groups). Limited number of studies examined other types of arrhythmia. Conclusion: We identified robust data on the relationship between CKD (eGFR and albuminuria) and AF. Reduced eGFR was associated with life-threatening ventricular arrhythmias. Our review highlights the need of future studies for non-AF arrhythmias, especially in the context of albuminuria.

Cognitive Impairment in Advanced Chronic Kidney Disease: The Canadian Frailty Observation and Interventions Trial

2016 ◽  
Vol 44 (6) ◽  
pp. 473-480 ◽  
Author(s):  
Rukhsana Foster ◽  
Simon Walker ◽  
Ranveer Brar ◽  
Brett Hiebert ◽  
Paul Komenda ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Kidney Disease ◽  
High Rate ◽  
Control Group ◽  
Cross Sectional ◽  
History Of ◽  
Poor Nutrition

Background: Chronic kidney disease (CKD) affects more than one third of older adults, and is a strong risk factor for vascular disease and cognitive impairment. Cognitive impairment can have detrimental effects on the quality of life through decreased treatment adherence and poor nutrition and results in increased costs of care and early mortality. Though widely studied in hemodialysis populations, little is known about cognitive impairment in patients with pre-dialysis CKD. Methods: Multicenter, cross-sectional, prospective cohort study including 385 patients with CKD stages G4-G5. Cognitive function was measured with a validated tool called the Montreal Cognitive Assessment (MoCA) as part of a comprehensive frailty assessment in the Canadian Frailty Observation and Interventions Trial. Cognitive impairment was defined as a MoCA score of ≤24. We determined the prevalence and risk factors for cognitive impairment in patients with CKD stages G4-G5, not on dialysis. Results: Two hundred and thirty seven participants (61%) with CKD stages G4-G5 had cognitive impairment at baseline assessment. When compared to a control group, this population scored lower in all domains of cognition, with the most pronounced deficits observed in recall, attention, and visual/executive function (p < 0.01 for all comparisons). Older age, recent history of falls and history of stroke were independently associated with cognitive impairment. Conclusions: Our study uncovered a high rate of unrecognized cognitive impairment in an advanced CKD population. This impairment is global, affecting all aspects of cognition and is likely vascular in nature. The longitudinal trajectory of cognitive function and its effect on dialysis decision-making and outcomes deserves further study.

scholarly journals Non-steroidal anti-inflammatory drugs in chronic kidney disease: a systematic review of prescription practices and use in primary care

2019 ◽  
Vol 13 (1) ◽  
pp. 63-71 ◽  
Author(s):  
Claire Lefebvre ◽  
Jade Hindié ◽  
Michael Zappitelli ◽  
Robert W Platt ◽  
Kristian B Filion
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Observational Research ◽  
Quality Improvement Intervention ◽  
Future Research ◽  
Cross Sectional ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

Abstract Background Chronic kidney disease (CKD) management focuses on limiting further renal injury, including avoiding nephrotoxic medications such as non-steroidal anti-inflammatory drugs (NSAIDs). We performed a systematic review to evaluate the prevalence of primary care NSAID prescribing in this population. Methods We systematically searched MEDLINE and Embase from inception to October 2017 for observational studies examining NSAID prescribing practices or use in CKD patients in a primary care setting. The methodological quality of included studies was assessed independently by two authors using a modified version of the Agency for Healthcare Research and Quality’s Methodological Evaluation of Observational Research checklist. Results Our search generated 8055 potentially relevant publications, 304 of which were retrieved for full-text review. A total of 14 studies from 13 publications met our inclusion criteria. There were eight cohort and three cross-sectional studies, two quality improvement intervention studies and one prospective survey, representing a total of 49 209 CKD patients. Cross-sectional point prevalence of NSAID use in CKD patients ranged from 8 to 21%. Annual period prevalence rates ranged from 3 to 33%. Meta-analysis was not performed due to important clinical heterogeneity across study populations. Conclusions Evidence suggests that NSAID prescriptions/use in primary care among patients with CKD is variable and relatively high. Future research should explore reasons for this to better focus knowledge translation interventions aimed at reducing NSAID use in this patient population.

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