Evidence mapPaperPMID 9214400Full record

ArticleAmerican journal of kidney diseases : the official journal of the National Kidney Foundation1997

Prevalence, recognition, and implications of mental impairment among hemodialysis patients.

A R Sehgal, S F Grey, P B DeOreo, P J Whitehouse

Registry-linked trialAbstract read
PubMed Publisher
In one paragraph

Article in American journal of kidney diseases : the official journal of the National Kidney Foundation, 1997. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03663049 (Trial of Statin Holiday in Patients Receiving Maintenance Dialysis), which is not on this map. Cited by 121 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
121citing papers in PubMed, 1 pooled it
2.0field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03663049 phase4unknown statusstarted 2018, after this paper: background citation

Trial of Statin Holiday in Patients Receiving Maintenance Dialysis

Ran2018Enrolled30Registered outcomes5Posted comparisons0ConditionsCardiovascular Diseases, ESRDArmsdiscontinue statin
Open the trial in the graph
3 · Its place in the literature

Who cites it

121 citing papers in PubMed, 1 synthesis or guideline pooled it, 272 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Trial
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  7. FGF-23 and cognitive performance in hemodialysis patients.Hemodialysis international. International Symposium on Home Hemodialysis · 2014
    Trial
  8. Effect of more frequent hemodialysis on cognitive function in the frequent hemodialysis network trials.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2013
    Trial
  9. Homocysteine lowering and cognition in CKD: the Veterans Affairs homocysteine study.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2009
    Trial
  10. Article
  11. Article
  12. Review
  13. Article
  14. Observational
  15. Article
  16. Review
  17. Article
  18. Observational
  19. Care pathways for patients with cognitive impairment and chronic kidney disease.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2025
    Review
  20. Review

61 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 3 institutions in 1 country.

A R SehgalMetroHealth Medical Center, Department of Medicine, Case Western Reserve University, Cleveland, OH 44109-1998, USA.
S F Grey
P B DeOreo
P J Whitehouse
MetroHealth · USMetroHealth Medical Center · USUniversity Hospitals of Cleveland · US

Funding

Overcoming Nutritional Barriers in Hemodialysis PtntsR01DK051472 · CASE WESTERN RESERVE UNIVERSITY · 1996 to 2005
$2.4M
NIDDK NIH HHS DK51472-01
6 · The paper itself

Abstract

The increasing age and co-morbidity of dialysis patients may be associated with an increase in the prevalence of Alzheimer's disease, stroke, and other causes of mental impairment. We sought to determine the prevalence, recognition, and implications of mental impairment among chronic hemodialysis patients. We administered the Mini Mental Status Exam (MMSE) to 336 randomly selected patients from three dialysis units. To determine recognition of mental impairment by health care providers, we compared MMSE scores with mental status assessments obtained from each patient's dialysis technician and medical record. To determine the clinical implications of mental impairment, we prospectively obtained Kt/V, albumin, protein catabolic rate, blood pressure, and hematocrit values. To determine the resource implications of mental impairment, we assessed staff time required to care for each patient as well as hospitalizations. We found that 22% of subjects had mild mental impairment (MMSE 18 to 23) and that 8% had moderate-severe mental impairment (MMSE 0 to 17). The sensitivity of technician and medical record mental status assessments were 57% and 15%, respectively. After adjusting for demographic and medical variables, low MMSE score was independently associated with low protein catabolic rate (odds ratio, 1.5; P = 0.02), increased technician time caring for patient after dialysis (odds ratio, 1.5; P = 0.005), and increased hospital days (odds ratio, 1.4; P = 0.03). In conclusion, there is a high prevalence of unrecognized mental impairment among hemodialysis patients that has adverse implications for protein nutritional status, staff time, and hospitalization. We recommend that clinicians routinely screen for mental impairment and target impaired patients for interventions to improve mental status and associated adverse outcomes.

Indexed as

Renal DialysisAdultAgedAged, 80 and overDiagnosis, DifferentialFemaleHumansMaleMental DisordersMental Status ScheduleMiddle AgedOdds RatioPrevalenceSensitivity and SpecificitySurvival Analysis

Identifiers

PMID9214400
OpenAlexW2124097908

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.