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[Retarded motor and cognitive development of young children with severe kidney disorders]
G M Hulstijn-Dirkmaat1, M L Jetten, E H Damhuis
1Afd. Medische Psychologie en Kindergeneeskunde, Academisch Ziekenhuis St. Radboud, Nijmegen.
Insights
Children with end-stage renal disease on dialysis show significant delays in motor and cognitive development. Early developmental screening and parental counseling are crucial for this vulnerable pediatric population.
Area of Science:
- Pediatric Nephrology
- Developmental Pediatrics
Context:
- Advances in medical technology enable treatment of young children with end-stage renal disease (ESRD) using continuous ambulatory peritoneal dialysis (CAPD) and hemodialysis (HD).
- Pediatric dialysis centers at university hospitals in Nijmegen, Utrecht, and Rotterdam participated.
Purpose:
- To investigate the effects of chronic renal failure on motor function and cognitive development in young children.
- To assess developmental parameters in children with ESRD compared to healthy controls.
Summary:
- A prospective study evaluated 18 infants and young children with chronic renal failure and 18 healthy controls.
- Patients exhibited significant delays in both motor and cognitive development compared to controls.
- Children undergoing CAPD or HD showed more pronounced developmental delays than those on conservative treatment.
Impact:
- Young children with ESRD requiring dialysis are at high risk for developmental retardation.
- Developmental screening and intensive parental counseling are strongly recommended for monitoring and supporting this vulnerable group.
Objective:
Medical and technical advances make it possible to treat young children with end-stage renal disease with far-reaching methods such as continuous ambulatory peritoneal dialysis (CAPD) and haemodialysis (HD). We investigated whether chronic renal failure has deleterious effects on motor function and cognitive development.
Setting:
The pediatric dialysis centres of the university hospitals of Nijmegen, Utrecht and Rotterdam.
Design:
Prospective study.
Methods:
18 patients (mean age 37 months) with chronic renal failure since infancy and 18 healthy children (mean age 35 months) as controls were assessed on cognitive and behavioural parameters. Nine patients and 17 control subjects were tested on their motor function.
Results:
A significant delay (more than one SD) was found in the motor as well as in the cognitive development of the patient group. Within this group a large difference was noticed between patients under conservative treatment (n = 8; mean dev. index 92.0) and those under CAPD or HD treatment (n = 10; mean dev. index 72.4).
Conclusion:
Young dialysis patients are evidently at risk for developmental retardation. Monitoring this vulnerable group by developmental screening and intensive counselling of the parents is strongly recommended.