Addressing cognitive impairment in drivers on hemodialysis through reaction time

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End-stage kidney disease affects cognition and is associated with sleep disorders (SD), both increasing reaction time (RT) and impairing decision-making capacity. Objective: To evaluate sleep disorders, age, dialysis duration, and education level on the RT of Brazilian drivers undergoing hemodialysis (HD) and the feasibility of the method employed. Methods: We used tablet-based software to test the RT of 35 drivers undergoing HD and 32 controls. We did a clinical interview, examination, and chart review. The data were summarized and analyzed, which included conducting multiple linear regression. Significance was considered for p<0.05. Results: RT evaluation was well-received and effortless to carry out. Most patients were male (82.9%); the mean age was 52 years; two-thirds had been on HD for less than four years; 47.5% had 9.5 years or less of education; 14.3% had restless legs syndrome/Willis-Ekbom disease (RLS/WED); 68.6% showed a high likelihood of obstructive sleep apnea (OSA). HD patients showed higher RT than controls (p<0.001), and RT was positively associated with age (p<0.001). Less than 9.5 years of education and being on dialysis for over four years are associated with longer RT (p<0.05). Those with RLS/WED had shorter RT (p<0.001), age remained a significant predictor in the regression model, and patients on HD had longer RT than controls (p<0.001). Conclusion: Testing the RT of drivers on HD in the clinic environment is fully feasible. Patients on HD had longer RT than controls. RLS/WED patients showed shorter RT, but, as age increases, the RT is longer.

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