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A longitudinal study of the cognitive function of children with renal failure
R S Fennell1, E B Fennell, R L Carter
1Department of Pediatrics, University of Florida, Gainesville 32610-0296.
Insights
Children with chronic renal failure show impaired neurocognitive function, particularly in visual-motor skills. Their performance on memory and learning tasks may decline over time compared to healthy peers.
Area of Science:
- Pediatric Nephrology
- Neuropsychology
- Developmental Pediatrics
Background:
- Chronic renal failure (CRF) significantly impacts children's overall health.
- Neurocognitive development in pediatric CRF patients requires thorough investigation.
Purpose of the Study:
- To longitudinally assess neuropsychological functioning in children with chronic renal failure.
- To compare cognitive performance across different treatment modalities (transplant, hemodialysis, peritoneal dialysis, medical management) against healthy controls.
Main Methods:
- Fifty-six children with CRF underwent serial neuropsychological testing every six months for two years.
- Each child was matched with healthy controls based on age, sex, and race.
- Repeated measures analysis of variance was used to compare longitudinal performance between groups.
Main Results:
- Children with CRF generally performed below their matched controls in verbal ability, visual perception, memory, and visual-motor skills.
- Visual-motor skills demonstrated the most significant clinical impairment.
- Renal subjects exhibited less improvement or deterioration in memory and learning skills compared to controls.
Conclusions:
- Pediatric chronic renal failure is associated with widespread neurocognitive deficits.
- Specific deficits in visual-motor skills and learning suggest potential long-term developmental challenges.
- Longitudinal monitoring is crucial for understanding the neurocognitive trajectory in children with CRF.
Abstract:
Fifty-six children with chronic renal failure who either received a kidney transplant, were hemodialyzed or peritoneally dialyzed, or who were being medically managed were given a series of neuropsychological tests every 6 months for a total of four testing sessions. Each child was matched by age, sex, and race to healthy children who received the same sequence of tests. The performance of each treatment group was compared with their controls longitudinally, using a repeated measure analysis of variance. In general, renal subjects performed at lower levels than their controls on tasks of verbal ability, visual perception, memory and visual motor skills. Visual motor performance was the most clinically affected. When compared with controls, the renal subjects did not improve as much or actually deteriorated on some measures of memory and learning skills.