Transplant Trial Watch

Subjective cognitive complaints in end-stage renal disease: a systematic review and meta-analysis.

Chan, F. H. F., et al.

Health Psychology Review 2022 [record in progress].

This study aimed to provide an overview of the existing literature on subjective cognitive complaints (SCCs) in adult end-stage renal disease (ESRD) patients.

Electronic databases including CINAHL, Ovid – All Resources, MEDLINE (PubMed), PsycINFO and Web of Science were searched. Study selection was performed by two independent reviewers. Data were extracted by one reviewer. The methodological quality of the included studies were assessed using the quality assessment tools developed by the National Institute of Health.

221 studies were included in the review.

The main outcomes of interest were measures of SCCs, frequency and severity of SCCs, differences in SCCs between treatment modalities (i.e. any dialysis modality or kidney transplantation), course of SCCs, association of SCCs with sociodemographic, clinical, and patient-reported variables, and association between SCCs and objective cognitive function.


CET Conclusions
The systematic review summarised the evidence regarding subjective cognitive complaints SCC) in end-stage renal disease. The authors hypothesised that kidney transplantation (KT) recipients would have a lower frequency and severity of SCCs than dialysis patients and that SCCs will improve after a KT. The comprehensive literature search identified 221 relevant studies (n=105,064) and 4,449 KT recipients. Data extraction was conducted by one reviewer and verified by two independent reviewers. The methodological quality was assessed using a relevant tool from the National Institute of Health. Narrative review of 11 studies in KT showed that that SCCs were reported from ‘none of the time’ to ‘a little of the time’ during the past month. Several studies showed a significant reduction in SCCs following KT and there was some evidence that this was maintained posttransplant. The authors encourage further research on understanding SCCs, which may allow early detection and intervention for patients at risk to develop cognitive impairments.

Trial registration
PROSPERO - CRD42021250125

Funding source
Non-industry funded