title: Clinical predictors of neurocognitive deficits in children with chronic kidney disease.
abstract: The purpose of the study was to explore associations between neurocognitive function and chronic kidney disease (CKD)-related clinical characteristics. Twenty-nine children, ages 7 to 19 years, with an estimated creatinine clearance (eCrCl) of 4-89 ml/min per 1.73 m2 body surface area were enrolled. Intellectual function (IQ), memory, and attention were measured and expressed as age-based standard scores. Clinical data were obtained by physical examination, laboratory testing, parental questionnaires and medical chart review. Pearson correlations and standard Student's t-tests were used to identify significant (P < 0.05) relationships between targeted clinical variables and neurocognitive scores. Increased CKD severity correlated with lower IQ (P = 0.001) and memory function (P = 0.02). Memory function was lower in children with longer duration of disease (P = 0.03). Similarly, IQ scores were lowest when kidney disease had started at a younger age (P = 0.03) and with a greater percent of life with CKD (P = 0.04). Our findings provide preliminary evidence that increased disease severity, longer duration of disease, and younger age of onset of kidney disease potentially place children with CKD at increased risk of neurocognitive deficits. Additional investigation is required to better quantify these risk factors, particularly regarding how much variability is accounted for by these specific risk factors.
authors.affiliation: UNC Kidney Center, University of North Carolina, 7007D Burnett-Womack CB #7155, Chapel Hill, NC 27599-7155, USA. slickers@unch.unc.edu
authors.forename: Jennifer
authors.initials: J
authors.lastname: Slickers
authors.forename: Peter
authors.initials: P
authors.lastname: Duquette
authors.forename: Stephen
authors.initials: S
authors.lastname: Hooper
authors.forename: Debbie
authors.initials: D
authors.lastname: Gipson
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000740:Anemia / Q000175:diagnosis; D002648:Child; D002653:Child Behavior Disorders / Q000175:diagnosis*; D015331:Cohort Studies; D002658:Developmental Disabilities / Q000175:diagnosis*; D018450:Disease Progression; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology; D006801:Humans; D006973:Hypertension / Q000175:diagnosis; D008607:Intellectual Disability / Q000175:diagnosis*; D007676:Kidney Failure, Chronic / Q000175:diagnosis* / Q000628:therapy; D016030:Kidney Transplantation; D007859:Learning Disabilities / Q000175:diagnosis; D008297:Male; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D017582:Renal Replacement Therapy