F. Olumba1, C. S. Hwang1, S. Levea1, B. Tanriover1, Y. Liang1, P. Vagefi1, M. MacConmara1, C. Hwang1 1UT Southwestern Medical Center,Dallas, TX, USA
Introduction:
Decreased cognitive function is associated with higher mortality in end stage renal disease (ESRD) and kidney transplant recipients. The Montreal Cognitive Assessment (MoCA) is a quick test often used to screen for cognitive impairment. In addition, the Stanford Integrated Psychosocial Assessment for Transplantation (SIPAT) is a scoring system increasingly used to quantify psychosocial risk. We questioned if MOCA and SIPAT scores would predict patients listed for kidney transplantation.
Methods:
A single center retrospective analysis was performed including all adult patients (age ≥18 years) with either CKD 5 or ESRD who were evaluated for kidney transplantation between January 1, 2016 and January 1, 2018. Non-parametric comparison tests were executed to assess differences in MoCA and SIPAT scores between subjects successfully listed for transplant and those not listed during the study period. Regression analysis was done to determine the relationship of MoCA and SIPAT scores to listing outcome.
Results:
880 patients were included for analysis. The average age at the time of referral or evaluation was 54.1± 13.8 years. The most common cause of ESRD was from diabetes and hypertension (26.8%), with the majority of subjects having ESRD (58.1%). During the study period, 255 (29.0%) of patients were placed on the waitlist. The median score for the non-listed group vs. listed groups was 24 vs. 25, however a score ≥ 23 oresulted in an OR of 1.88 (95% CI 1.18 to 2.99, p= 0.0078) for being placed on the transplant list. Furthermore, of those patients not listed with MOCA ≥ 23 no statistically significant difference was found between those listed with respect to age, sex, race, etiology of ESRD, dialysis use or six-minute walk distance. Interestingly, SIPAT scores of those of ≥ 23 non-listed patients were significantly higher (9 v 12) indicating increased psychosocial (p= 0.003).
Conclusion:
Combining MOCA and SIPAT scores may have useful predictive value to determine suitable candidates for kidney transplantation.
