Interventions to improve cognitive performance in chronic kidney disease: A scoping review
Bibliographic record
Abstract
RATIONALE & OBJECTIVE: 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. STUDY DESIGN: Scoping review following JBI methodology. SETTING AND STUDY POPULATIONS: Adults (≥18 years) with CKD or kidney failure. SELECTION CRITERIA FOR STUDIES: 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. DATA EXTRACTION: Characteristics of interventions, populations studied, and outcomes investigated. ANALYTICAL APPROACH: Descriptive statistics and narrative syntheses. RESULTS: 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. LIMITATIONS: Abstract screening not performed in duplicate; non-English studies excluded. CONCLUSION: 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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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.025 | 0.100 |
| Meta-epidemiology (narrow) | 0.002 | 0.002 |
| Meta-epidemiology (broad) | 0.006 | 0.008 |
| Bibliometrics | 0.024 | 0.021 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.007 | 0.005 |
| Open science | 0.003 | 0.004 |
| Research integrity | 0.005 | 0.003 |
| Insufficient payload (model declined to judge) | 0.007 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".