Kids with chronic kidney disease have poor cognitive function
“Poor cognitive and educational outcomes can have some serious and long-term consequences for children and adolescents with chronic kidney disease” says Dr. Kerry Chen from the Centre for Kidney Research, and the Sydney School of Public Health, The University of Sydney.
Under the umbrella of the Kids' Health and Wealth Study (KCAD), Dr Chen and colleagues reviewed observational studies of children and young people with CKD aged 21 years or younger that assessed neurocognitive or educational outcomes. Data was included from 34 studies (25 cross-sectional with 2,095 participants and nine cohort with 991 participants).
The researchers found that children with CKD may have low-average cognition compared with the general population, with mild deficits observed across academic skills, executive function, and visual and verbal memory. On average, those with CKD scored about 10 IQ points lower than those without. These IQ scores varies across CKD stage, depending on whether children were on dialysis, pre- or post-transplant, with those on dialysis having the lowest score.
“In addition to the chronicity and severity of the condition itself, children and young people with chronic kidney disease (CKD) can spend a long time away from the classroom while on dialysis or recovering from a transplant,” said Dr Chen. “They may lose interest, withdraw or progress poorly through school, and this matters especially as they transition into adulthood.”
The current evidence suggests that children on dialysis may be at greatest risk compared with children with mild-to-moderate stage CKD and transplant recipients. This may be attributable to unique biochemical/pathophysiological mechanisms, such as anaemia leading to poor perfusion of the brain; as well as the socio-psychological effects of complex treatment regimens for CKD causing poor sleep, social isolation, and time away from school.
“Ultimately, we want to improve our understanding of how chronic kidney disease impacts children and adolescents so that kids and their families are holistically supported as they navigate a challenging landscape,” remarked Kerry Chen.