Neuropsychological performance after kidney transplantation: a comparison between transplant types and in relation to dialysis and normative data

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Abstract
Background. Neuropsychological (NP) performance after kidney transplantation (TX) has received little attention. This study compared NP functioning between dialysis and transplant patients and between living-related donor (LRD) and cadaver (CAD) transplant recipients. The association between immunosuppressive medication and NP outcomes was also examined. Methods. One hundred and seventeen transplant recipients (25 LRD and 92 CAD patients) and 145 dialysis patients (77 haemodialysis and 68 peritoneal dialysis) were administered an NP test battery to assess learning and verbal recall, attention and concentration, and psychomotor abilities/speed. Biochemical markers of renal function were also assessed. Results. Overall, transplant patients showed normal cognitive functioning in all domains assessed. NP performance was found to be equivalent in both transplant groups and in patients on cyclosporin and those on tacrolimus. ANCOVAs showed that TX patients performed significantly better than dialysis patients on selective NP tests, i.e. the two memory tasks and two out of the four tests of attention. No differences were found in motor tasks. Conclusions. Our results reveal no evidence of NP deficits in TX patients. The NP advantage of TX relative to dialysis is evident mainly in verbal memory.