{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:05:14Z","timestamp":1753891514719,"version":"3.41.2"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,9,14]],"date-time":"2023-09-14T00:00:00Z","timestamp":1694649600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nephrol."],"abstract":"<jats:sec><jats:title>Why should we screen?<\/jats:title><jats:p>The prevalence of cognitive impairment in kidney transplant recipients (KTRs) is up to 58%. The 10-year graft loss and mortality rates are above 30% and 50%, respectively, and executive malfunctioning increases disadvantageous outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>What causes cognitive impairment in KTRs?<\/jats:title><jats:p>Strong risk factors are older age and chronic kidney disease. However, causes are multifactorial and include cardiovascular, cerebrovascular, neurodegenerative, inflammatory, uremic, psychiatric, and lifestyle-related susceptibilities.<\/jats:p><\/jats:sec><jats:sec><jats:title>How should we screen?<\/jats:title><jats:p>KTR-specific validated instruments or strategies do not exist. The central element should be a multidomain cognitive screening test that is sensitive to mild cognitive impairment, corrects for age and education, and includes executive functions testing. Cognitive trajectories, effects on everyday life and psychiatric comorbidities should be assessed by integrating the perspectives of both patients and knowledgeable informants.<\/jats:p><\/jats:sec><jats:sec><jats:title>When should we screen?<\/jats:title><jats:p>Screening should not be postponed if there is suspicion of impaired cognition. Different time points after transplantation tend to have their own characteristics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Who should conduct the screening?<\/jats:title><jats:p>Screening should not be limited to specialists. It can be carried out by any healthcare professional who has received a limited amount of training.<\/jats:p><\/jats:sec><jats:sec><jats:title>What are the benefits of screening?<\/jats:title><jats:p>Screening does not provide a diagnosis. However, suggestive results change care in multiple ways. Goals are: Initiation of professional dementia work-up, securing of adherence, anticipation of potential complications (delirium, falls, frailty, functional impairment, malnutrition, etc.), mitigation of behavioral disorders, adjustment of diagnostic and therapeutic \u201cload\u201d, reduction of caregiver burden and meeting of changing needs. We summarize data on the prevalence, risk factors and sequelae of cognitive impairment in KTRs. We also discuss the requirements for appropriate screening strategies and provide guiding principles regarding appropriate and safe care.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneph.2023.1238501","type":"journal-article","created":{"date-parts":[[2023,9,15]],"date-time":"2023-09-15T01:28:50Z","timestamp":1694741330000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["Screening of cognitive performance in kidney transplant recipients: a mini review"],"prefix":"10.3389","volume":"3","author":[{"given":"Simeon","family":"Schietzel","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reto W.","family":"Kressig","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Uyen","family":"Huynh-Do","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2023,9,14]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1186\/s12882-017-0570-1","article-title":"Prevalence and correlates of cognitive impairment in kidney transplant recipients","volume":"18","author":"Gupta","year":"2017","journal-title":"BMC Nephrol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2016080816","article-title":"Dementia and Alzheimer's disease among older kidney transplant recipients","volume":"28","author":"McAdams-DeMarco","year":"2017","journal-title":"J Am Soc Nephrol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.14798","article-title":"Pre-transplant cognitive screening is a poor predictor of post-transplant cognitive status","volume":"36","author":"Gupta","year":"2022","journal-title":"Clin Transplant"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2019.00791","article-title":"Prevalence and correlates of cognitive impairment in kidney transplant patients using the DemTect-results of a KTx360 substudy","volume":"10","author":"N\u00f6hre","year":"2019","journal-title":"Front Psychiatry"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1017\/S1355617709990221","article-title":"Cognitive performance before and after kidney transplantation: a prospective controlled study of adequately dialyzed patients with end-stage renal disease","volume":"15","author":"Harciarek","year":"2009","journal-title":"J Int Neuropsychol Soc"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1159\/000444334","article-title":"Cognitive function and white matter changes associated with renal transplantation","volume":"43","author":"Gupta","year":"2016","journal-title":"Am J Nephrol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"e14425","DOI":"10.1111\/ctr.14425","article-title":"Cognitive impairment burden in older and younger adults across the kidney transplant care continuum","volume":"35","author":"Chu","year":"2021","journal-title":"Clin Transplant"},{"key":"B8","doi-asserted-by":"publisher","first-page":"100560","DOI":"10.1016\/j.xkme.2022.100560","article-title":"Neurocognitive function changes following kidney transplant: A prospective study","volume":"4","author":"Binari","year":"2022","journal-title":"Kidney Med"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfl385","article-title":"Cognitive functioning pre- to post-kidney transplantation\u2013a prospective study","volume":"21","author":"Griva","year":"2006","journal-title":"Nephrol Dial Transplant"},{"key":"B10","article-title":"The modified mini-mental state (3MS) examination","volume":"48","author":"Teng","year":"1987","journal-title":"J Clin Psychiatry"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1002\/gps.1042","article-title":"DemTect: a new, sensitive cognitive screening test to support the diagnosis of mild cognitive impairment and early dementia","volume":"19","author":"Kalbe","year":"2004","journal-title":"Int J Geriatr Psychiatry"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2005.53221.x","article-title":"The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment","volume":"53","author":"Nasreddine","year":"2005","journal-title":"J Am Geriatr Soc"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.3233\/JAD-180416","article-title":"A systematic review and meta-analysis on the prevalence of dementia in Europe: estimates from the highest-quality studies adopting the DSM IV diagnostic criteria","volume":"66","author":"Bacigalupo","year":"2018","journal-title":"J Alzheimers Dis"},{"key":"B14","doi-asserted-by":"publisher","first-page":"283","DOI":"10.1186\/s12882-022-02900-w","article-title":"Prevalence of frailty and cognitive impairment in older transplant candidates - 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