%0 Journal Article
%T Prevalence and Pattern of Neurocognitive Impairment in Nigerians with Stages 3 to 5 Chronic Kidney Disease
%A U. E. Williams
%A M. O. Owolabi
%A A. Ogunniyi
%A E. O. Ezunu
%J ISRN Neurology
%D 2013
%R 10.1155/2013/374890
%X Background. Cognitive impairment with its negative effect on quality of life has been reported in chronic kidney disease (CKD). The paucity of the literature on cognitive impairment in Africans with CKD prompted this study. Objectives. To determine the frequency and pattern of cognitive impairment in patients with stages 3 to 5 CKD. Methods. We studied 79 consecutive consenting adults with a National Kidney Foundation (NKF) stage 3 to 5 CKD based on their estimated glomerular filtration rate using the Cockcroft-Gault formula. The controls consisted of healthy demographically matched subjects. Community screening instrument for dementia (CSI＊D), trail making test A (TMTA), and trail making test B (TMTB) were used for cognitive assessment. Results. More CKD patients had cognitive impairment compared with controls using CSI＊D (51.9% versus 2.5%, ); TMTA (53.2% versus 0%, ); and TMTB (40% versus 0%, ). The odds of having cognitive impairment increased in the presence of CKD when assessed using CSI＊D (ORˋ=ˋ2.026; CIˋ=ˋ1.607每2.555); TMTA (ORˋ=ˋ3.13; CIˋ=ˋ2.40每4.09) and TMTB (ORˋ=ˋ3.22; CIˋ=ˋ2.42每4.25). CKD patients performed poorer on tests of executive function TMTA ( ) and TMTB ( ) while CSI＊D showed significantly lower scores on multiple cognitive domains. Conclusions. Significant cognitive impairment in multiple domains exists among Nigerians with CKD. 1. Introduction Chronic kidney disease (CKD) is a growing public health problem [1每4] with evidence pointing to an increasing incidence and prevalence worldwide [5, 6]. However, it is grossly underdiagnosed in Nigeria and other developing countries. The hospital frequency in Nigeria ranges between 1.6 and 8% of hospital admissions [7]. Although CKD affects all races equally, end-stage renal disease (ESRD) is four times more prevalent in blacks than whites in the United States [1]. CKD is found in persons of all ages, but higher incidence rates occur in patients at or above 65 years of age [8每10], an age range that is traditionally associated with a high prevalence of cognitive impairment. However, a lower average age has been reported among Nigerians with CKD [7]. Although data on prevalence and pattern of cognitive impairment among Nigerians with CKD is scanty, in other climes a high incidence of cognitive impairment has been reported among patients with CKD [1, 11每13]. Murray et al. [14] observed in their study of 338 haemodialysis patients that 37.0% had severe cognitive impairment which was more than three times the 5每10% estimated prevalence of dementia in the US population-based studies. Sehgal et al.
%U http://www.hindawi.com/journals/isrn.neurology/2013/374890/