Psychosocial and Biomedical Predictors of Attention and Memory in End-Stage Renal Disease Patients

This study examined the neurocognitive functioning of 554 end-stage renal disease (ESRD) patients to determine the underlying factor structure of tests of attention and memory and to assess the differential impact of psychosocial and biomedical variables on these factors. Analysis revealed three underlying factors: Sustained Attention, Focused Attention, and Memory Recall. Hierarchical regression analyses revealed that psychosocial and biomedical variables were most strongly related to the Focused Attention factor. Education, vocabulary score, age, race, age by creatinine, creatinine, and renal replacement therapy accounted for 30% of variance in Focused Attention; sex, depression, and hypertension were unrelated. After controlling for demographic and medical variables, type of renal replacement therapy was a statistically, but not clinically, significant predictor of Focused Attention, with peritoneal dialysis associated with better attentional performance relative to hemodialysis. The potential relationship between focused attention and compliance is discussed.