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Investigating how problems with memory and other thought processes might affect treatment-related decision-making in patients with CKD

20 May 2024

Dr Kerry-Lee Rosenberg from University College London has received an Andy Cole Fund Award clinical training fellowship of £318,000 to study the impact of undiagnosed problems with memory and other thought processes (known as cognitive impairment, CI) in a multi-ethnic population with advanced chronic kidney disease (CKD). 

The problem

CI is a term used when a person experiences difficulties with some thought-related processes, such as memory, focus, decision-making and problem-solving. Patients with chronic kidney disease (CKD) are at higher risk of CI, but it is often not diagnosed. CI can affect how patients manage their condition and make potentially complex decisions about their treatment.

Previous studies have investigated how common CI is in patients with CKD suggesting that between 19% and 61% experience symptoms of this condition. However, most of these studies only included English speakers, and the majority of participants were white, so they did not capture the experiences of all kidney patients.  

Dr Kerry-Lee Rosenberg
Dr Kerry-Lee Rosenberg

The solution 

Kerry and her team aim to find out how common CI is in kidney patients from a range of backgrounds. She will also work to understand the impact that undiagnosed CI can have on treatment decision-making and quality of life for patients with CKD who choose to have dialysis or supportive care. 

This patient-centred research will start with interviews to explore the background and social factors that have influenced individual decision-making around treatments, and to understand their feelings about joining a research study of this type. 

Next, Kerry will design a questionnaire to look at quality of life, how much the patients are able to do for themselves, and sociodemographic information (such as ethnicity, religion, first language, education, income and social support). Participants will also be asked to complete a short screening test which has been designed for multicultural populations. They will then be followed up by carefully looking at their NHS healthcare records for up to two years to understand their treatment journey. 

What this might mean for patients 

This work will help us to understand how many CKD patients are impacted by CI and how this could affect their treatment decision-making. This work will help to identify new ways to support patients, may inform future research, and guide clinical practice to improve the information and help given to patients in their kidney journeys. 

“This research focuses on a crucial point in the kidney patient journey and will help us to better understand the challenges our patients face as they make decisions about their care. Improving the ways in which we provide individualised, holistic support to patients and producing research which encompasses our diverse kidney patient community is really central to this work.” Dr Kerry-Lee Rosenberg 

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