Interventions to improve cognitive performance in chronic kidney disease: A scoping review.

<h4>Rationale & objective</h4>Cognitive impairment is commonly associated with chronic kidney disease (CKD. A number of intervention approaches have the potential to improve cognitive performance in CKD. Our objective was to characterize interventions studied to improve cognitive per...

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Main Authors: Janine Farragher, Urooj K Khan, Kevin Yau, Katherine E Stewart, Tyrone G Harrison, Lisa Engel, Samantha E Seaton, Maoliosa Donald, Brenda R Hemmelgarn
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2025-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0329815
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author Janine Farragher
Urooj K Khan
Kevin Yau
Katherine E Stewart
Tyrone G Harrison
Lisa Engel
Samantha E Seaton
Maoliosa Donald
Brenda R Hemmelgarn
author_facet Janine Farragher
Urooj K Khan
Kevin Yau
Katherine E Stewart
Tyrone G Harrison
Lisa Engel
Samantha E Seaton
Maoliosa Donald
Brenda R Hemmelgarn
author_sort Janine Farragher
collection DOAJ
description <h4>Rationale & objective</h4>Cognitive impairment is commonly associated with chronic kidney disease (CKD. A number of intervention approaches have the potential to improve cognitive performance in CKD. Our objective was to characterize interventions studied to improve cognitive performance for adults with CKD across all categories of severity, including kidney failure.<h4>Study design</h4>Scoping review following JBI methodology.<h4>Setting and study populations</h4>Adults (≥18 years) with CKD or kidney failure.<h4>Selection criteria for studies</h4>We searched 5 electronic databases for studies published up to April 5, 2024. Eligible sources were primary research studies that investigated any intervention targeting cognition in adults (≥18 years) with CKD or kidney failure. Full-text article screening was performed in duplicate.<h4>Data extraction</h4>Characteristics of interventions, populations studied, and outcomes investigated.<h4>Analytical approach</h4>Descriptive statistics and narrative syntheses.<h4>Results</h4>Seventy-one studies were included. Over half (n = 37, 52%) were conducted within the past five years, and most studies (n = 47, 66%) targeted people on maintenance hemodialysis therapy. Just over one-third of studies investigated pharmacological interventions, with much of the pharmacological or medical research focusing on anemia management or dialysis adequacy. Although recent research has expanded in focus, many other purported mechanisms of cognitive dysfunction in CKD remain understudied in interventional research. Exercise training (n = 14) was the most common nonpharmacological approach studied, but few studies have explored other promising nonpharmacological approaches such as cognitive rehabilitation interventions.<h4>Limitations</h4>Abstract screening not performed in duplicate; non-English studies excluded.<h4>Conclusion</h4>Research into cognitive interventions for people with kidney disease has primarily focused on the hemodialysis population and investigated erythropoietin stimulating agents, frequent or prolonged dialysis, and exercise, although there has been recent growth of research activity into other interventions. Future research should aim to address a broader range of purported pathophysiological mechanisms of cognitive impairment in CKD, investigate interventions for predialysis and peritoneal dialysis patients, and explore the impacts of established cognitive rehabilitation approaches.
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spelling doaj-art-d2e241e9d6974683a4ef92affc6cdeaf2025-08-23T05:32:04ZengPublic Library of Science (PLoS)PLoS ONE1932-62032025-01-01208e032981510.1371/journal.pone.0329815Interventions to improve cognitive performance in chronic kidney disease: A scoping review.Janine FarragherUrooj K KhanKevin YauKatherine E StewartTyrone G HarrisonLisa EngelSamantha E SeatonMaoliosa DonaldBrenda R Hemmelgarn<h4>Rationale & objective</h4>Cognitive impairment is commonly associated with chronic kidney disease (CKD. A number of intervention approaches have the potential to improve cognitive performance in CKD. Our objective was to characterize interventions studied to improve cognitive performance for adults with CKD across all categories of severity, including kidney failure.<h4>Study design</h4>Scoping review following JBI methodology.<h4>Setting and study populations</h4>Adults (≥18 years) with CKD or kidney failure.<h4>Selection criteria for studies</h4>We searched 5 electronic databases for studies published up to April 5, 2024. Eligible sources were primary research studies that investigated any intervention targeting cognition in adults (≥18 years) with CKD or kidney failure. Full-text article screening was performed in duplicate.<h4>Data extraction</h4>Characteristics of interventions, populations studied, and outcomes investigated.<h4>Analytical approach</h4>Descriptive statistics and narrative syntheses.<h4>Results</h4>Seventy-one studies were included. Over half (n = 37, 52%) were conducted within the past five years, and most studies (n = 47, 66%) targeted people on maintenance hemodialysis therapy. Just over one-third of studies investigated pharmacological interventions, with much of the pharmacological or medical research focusing on anemia management or dialysis adequacy. Although recent research has expanded in focus, many other purported mechanisms of cognitive dysfunction in CKD remain understudied in interventional research. Exercise training (n = 14) was the most common nonpharmacological approach studied, but few studies have explored other promising nonpharmacological approaches such as cognitive rehabilitation interventions.<h4>Limitations</h4>Abstract screening not performed in duplicate; non-English studies excluded.<h4>Conclusion</h4>Research into cognitive interventions for people with kidney disease has primarily focused on the hemodialysis population and investigated erythropoietin stimulating agents, frequent or prolonged dialysis, and exercise, although there has been recent growth of research activity into other interventions. Future research should aim to address a broader range of purported pathophysiological mechanisms of cognitive impairment in CKD, investigate interventions for predialysis and peritoneal dialysis patients, and explore the impacts of established cognitive rehabilitation approaches.https://doi.org/10.1371/journal.pone.0329815
spellingShingle Janine Farragher
Urooj K Khan
Kevin Yau
Katherine E Stewart
Tyrone G Harrison
Lisa Engel
Samantha E Seaton
Maoliosa Donald
Brenda R Hemmelgarn
Interventions to improve cognitive performance in chronic kidney disease: A scoping review.
PLoS ONE
title Interventions to improve cognitive performance in chronic kidney disease: A scoping review.
title_full Interventions to improve cognitive performance in chronic kidney disease: A scoping review.
title_fullStr Interventions to improve cognitive performance in chronic kidney disease: A scoping review.
title_full_unstemmed Interventions to improve cognitive performance in chronic kidney disease: A scoping review.
title_short Interventions to improve cognitive performance in chronic kidney disease: A scoping review.
title_sort interventions to improve cognitive performance in chronic kidney disease a scoping review
url https://doi.org/10.1371/journal.pone.0329815
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