Cognitive impairment and dialysis

Posted by ggibson @ggibson, Dec 31, 2020

My wife has been in dialysis for about 2 years now. When her kidney’s finally dropped the mike and left the room she spent several weeks in hospital. She was fairly confused during that (not knowing where she was and the like). This much time later she’s doing OK, mostly managing her relatively complex medication regimen (17 drugs at last count), she drives herself to and from dialysis but her short term memory is marginal and has problem with day/date. I get asked the same question over and over, which to be fair, doesn’t bother me. It feels like her cognition is getting a little worse over time but it’s hard to tell because one day is a lot like the last. The biggest factors appear to dialysis (more confused after dialysis but before a serious nap) and the other is just general fatigue. Both make her more likely to be confused. Her medical team, who are pretty good, don’t want to make any projections into the future and I’ve had a hard time finding academic literature that talks about whether cognition changes over time with continuing dialysis. I’d be grateful for any experience the group has had. I fell like I’m more likely to be prepared if I know the range of what’s ahead. I know accurate projections aren’t possible, just wondering if there’s experience in the community. Thanks, George

@ggibson Im really sorry to hear that your wife is having some problems with dialysis. There is a support group for dialysis patients that you may want to get involved with. The link is below. I know the members there will help you. Will you check them out?
I’ll also ask @rosemarya to get in on this conversation.
https://connect.mayoclinic.org/discussion/support-for-dialysis-patients/

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@ggibson, my own experience has been mild to moderate short-term memory loss and slowed problem-solving/decision-making shortly after I went into End Stage. This contiinued the first 2-3 weeks of dialysis then slowly began to improve, especially after post-dialysis power naps. At age 75 as a retiree and natural-born hermit, I tend to lose track of what day of the week it is anyway and occasionally can't remember someone's name or the name of an object but this was happening before dialysis and I can't tell that it's worse after 4 months of hemodialysis. Am currently a week off dialysis due to almost normal labs and slightly (temporary, I believe) increased renal function and feel no ill effects 3 days post last dialysis, including good cognition. Hope this helps but every situation and every person is different. With my nursing background, I can confirm your observation about your wife's confusion prior to dialysis – without dialysis, cognition and other symptoms become much worse unless there's some resumption of kidney function. So loving of you to be patient and kind with your wife!

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@becsbuddy

@ggibson Im really sorry to hear that your wife is having some problems with dialysis. There is a support group for dialysis patients that you may want to get involved with. The link is below. I know the members there will help you. Will you check them out?
I’ll also ask @rosemarya to get in on this conversation.
https://connect.mayoclinic.org/discussion/support-for-dialysis-patients/

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Thanks so much! I will indeed look into the group.

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@kamama94

@ggibson, my own experience has been mild to moderate short-term memory loss and slowed problem-solving/decision-making shortly after I went into End Stage. This contiinued the first 2-3 weeks of dialysis then slowly began to improve, especially after post-dialysis power naps. At age 75 as a retiree and natural-born hermit, I tend to lose track of what day of the week it is anyway and occasionally can't remember someone's name or the name of an object but this was happening before dialysis and I can't tell that it's worse after 4 months of hemodialysis. Am currently a week off dialysis due to almost normal labs and slightly (temporary, I believe) increased renal function and feel no ill effects 3 days post last dialysis, including good cognition. Hope this helps but every situation and every person is different. With my nursing background, I can confirm your observation about your wife's confusion prior to dialysis – without dialysis, cognition and other symptoms become much worse unless there's some resumption of kidney function. So loving of you to be patient and kind with your wife!

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WOW! Thanks so much for sharing. I have to admit that I've never been so aware of the power of a nap. My wife is a painter so also a bit of a hermit and, like you, that day/date thing never was much of a priority for us. Like everybody these days, the days run into each other for me as well and my most common first response to what day is it is "blursday" (then I look up the real answer). Congratulations on your time off! May your labs stay good. Dialysis is so much more taxing than it appears. My wife has been patient and kind with me during the entirety of the 34 years we've been married (I can be a bit of the absent minded professor sort) so turn about is more than fair play.

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