Cognitive-Psychomotor Functions and Nutritional Status in Maintenance Hemodialysis Patients: Are They Related? Josipa Radic ´, 1 Dragan Ljutic, 2 Mislav Radic ´, 2 Vedran Kovacic, 1 Katarina Dodig C ´ urkovic ´, 3 and Milenka Sain 1 Departments of 1 Nephrology, and 2 Rheumatology and Clinical Immunology, University Hospital Split, Split, Croatia; and 3 Department of Psychiatry, University Hospital Osijek, Osijek, Croatia Abstract: Both cognitive impairment and malnutrition are common in hemodialysis patients and associated with adverse clinical outcome.The aim of the study was to inves- tigate performance on a detailed cognitive and psychomotor battery in maintenance hemodialysis patients in corre- lation to nutritional status. A selected population of 65 adult (20 females and 45 males, aged 57.84  12.28 years) hemodialysis (4.78  3.62 years) patients were investigated. The total time of test solving was correlated with Dialysis Malnutrition Score (DMS) in tests of simple visual discrimination of signal location (r = 0.215, P = 0.042), simple convergent visual orientation (r = 0.262, P = 0.020), and convergent thinking (r = 0.244, P = 0.034). The minimum time of test solving was also correlated with DMS in the test of simple convergent visual orientation (r = 0.227, P = 0.038), and in the test of convergent thinking (r = 0.223, P = 0.048).Total ballast,as a descriptor of stability in reaction time, was correlated with DMS in the test of simple visual discrimination of signal location (r = 0.281, P = 0.012), and in a test of short term memory actualization (r = 0.239, P = 0.028). Furthermore, signifi- cant correlation was noted between body mass index, serum creatinine, total cholesterol and albumin level with cognitive–psychomotor performance. Hemodialysis patients with a poorer nutritional status performed worse on cognitive and psychomotor tests. Further research is needed to assess the effects of treating malnutrition on cognitive–psychomotor performance in these patients. Key Words: Malnutrition, Cognitive–psychomotor func- tion, hemodialysis. Patients with end-stage renal disease (ESRD) on maintenance hemodialysis (HD) have high risk of development of cognitive impairment. Moderate and severe cognitive impairment is common and undiag- nosed in this population of patients (1). Also, cogni- tive impairment has been associated with decreased quality of life (2) and increased risk of death in HD patients (3). Furthermore, malnutrition is considered to be one of the late complications of chronic renal failure. It is frequent, affects quality of life, and is linked to increased risk of morbidity and mortality (4–6). Many studies have reported the presence of malnutrition in a large number of dialysis patients (7,8). In the French national cooperative study life threatening malnutrition was present in up to 36% of the patients, with low protein intake and low dialysis efficiency associated with the presence of malnutri- tion (7). Several previous studies demonstrated that HD patients eat less protein and fewer calories than prescribed which is associated with a higher rate of malnutrition (8–10). Nutritional status and cognitive function in HD patients are frequently ignored in many HD centers while simple methods of nutri- tional and cognitive assessment could have a favor- able impact on patient care and quality of life. Because cognitive impairment may impact decision making as well as ability to adhere to dietary modi- fication and medical compliance (11), and could be associated with poor oral intake that could further increase mortality by malnutrition, we hypothesize that cognitive–psychomotor functions are related to nutritional status in patients on maintenance HD. The computer-based system Complex Reaction- meter Drenovac (CRD series) is based on solving Received April 2011; revised June 2011 Address correspondence and reprint requests to Dr Mislav Radic ´, Department of Rheumatology and Clinical Immunology, University Hospital Split, Split 21000, Croatia. Email: mislavradic@ gmail.com Therapeutic Apheresis and Dialysis 15(6):532–539 doi: 10.1111/j.1744-9987.2011.00995.x © 2011 The Authors Therapeutic Apheresis and Dialysis © 2011 International Society for Apheresis 532