title: Neuropsychological profile of children with kidney transplants.
abstract: BACKGROUND
  Varying results on the cognitive outcome of children who have undergone kidney transplantation (KTx) have raised concern for specific neurocognitive difficulties.
  
  
  METHODS
  Fifty children with KTx were assessed at a mean age of 11.1 (SD 3.2; range 6.3-16.4), on average 6.9 (SD 3.6; range 1.0-14.1) years post-operatively. A standardized test of intelligence [Wechsler Intelligence Scale for Children (WISC-III)] and neuropsychological tests from NEPSY-II were administered. The neuropsychological profile of KTx children was compared to that of a control group matched for gender, age and maternal education.
  
  
  RESULTS
  The KTx children had a lower intelligence quotient (83.9) than the test norms (100.0, P < 0.001). On neuropsychological assessment, the KTx group scored generally lower than the control group did (P < 0.001). The difference was evident in both the verbal and visuospatial domains, on a sub-test of complex auditory attention, verbal working memory and facial affect recognition. When children with neurological co-morbidity were excluded, the remaining group still scored lower than the controls did on Comprehension of Instructions (P = 0.06), Design Copying (P = 0.007) and Affect Recognition (P = 0.018). A better cognitive outcome was mainly associated with the absence of neurological co-morbidity, younger age, shorter disease duration and sustained kidney function. Children with congenital nephrosis had a similar outcome to those with other diagnoses.
  
  
  CONCLUSIONS
  KTx children exhibit a pattern of effects in their cognitive outcome in which both the visuospatial and language domains are affected, but visual memory and simple auditory attention remain intact. Patients without neurological co-morbidity exhibit impairment in receptive language, visuospatial functions and in recognizing emotional states.
authors.affiliation: Institute of Behavioural Sciences, University of Helsinki, Helsinki, Finland. anu.haavisto@helsinki.fi
authors.forename: Anu
authors.initials: A
authors.lastname: Haavisto
authors.forename: Marit
authors.initials: M
authors.lastname: Korkman
authors.forename: Christer
authors.initials: C
authors.lastname: Holmberg
authors.forename: Hannu
authors.initials: H
authors.lastname: Jalanko
authors.forename: Erik
authors.initials: E
authors.lastname: Qvist
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology* / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007361:Intelligence Tests; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000523:psychology*; D008297:Male; D009404:Nephrotic Syndrome / Q000175:diagnosis / Q000209:etiology / Q000523:psychology; D009483:Neuropsychological Tests; D011379:Prognosis; D012307:Risk Factors