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Published on: April 12, 2021
Neurocognitive functions of pediatric kidney transplant recipients
Marta Molnar-Varga1,2, Marta Novak3,4, Attila J Szabo5,6
1Institute for the Psychology of Special Needs, Faculty of Special Education, ELTE University, Budapest, Hungary. marta.molnar@barczi.elte.hu.
Insights
Children with kidney transplants show impaired neurocognitive function compared to healthy peers. Socioeconomic factors and disease severity, not lab values, are linked to these cognitive deficits in pediatric kidney transplant recipients.
Area of Science:
- Pediatric Nephrology
- Neuroscience
- Developmental Psychology
Background:
- End-stage renal disease (ESRD) in children is linked to impaired neurocognitive development.
- Limited data exists on neurocognitive function in pediatric kidney transplant recipients.
Purpose of the Study:
- To compare cognitive functions in pediatric kidney transplant recipients versus healthy controls.
- To identify factors associated with neurocognitive dysfunction in these children.
Main Methods:
- Cross-sectional analysis of 35 kidney transplant recipients and 35 healthy children.
- Cognitive function assessed using the Woodcock-Johnson International Edition (WJIE).
- Collected data on laboratory values, comorbidities, and social characteristics.
Main Results:
- Transplant recipients had significantly lower Full Scale IQ scores (85 vs 107, p <0.001).
- Lower maternal education, medical comorbidities, earlier dialysis onset, longer dialysis duration, and longer hospitalization were associated with lower cognitive scores.
- No association found between laboratory values and cognitive scores.
Conclusions:
- Pediatric kidney transplant recipients exhibit neurocognitive impairments.
- Socioeconomic status markers and disease severity factors are associated with these impairments.
Background:
End-stage renal disease (ESRD) in children is associated with impaired neurocognitive function and development. However, data on factors associated with neurocognitive dysfunctions in children with kidney transplants are limited.
Methods:
We conducted a cross-sectional analysis comparing cognitive functions (using the Woodcock-Johnson International Edition, WJIE) in 35 kidney transplant and 35 healthy control children. Data on laboratory measurements, comorbidities, and social characteristics were collected.
Results:
Transplant children had significantly worse scores on the intelligence quotient (IQ) test compared with controls [Full Scale IQ score 85 (26) vs 107 (10), p <0.001]. Lower maternal education level was significantly associated with lower WJIE cognitive test scores; however, no association was found between laboratory values and WJIE scores. Among children with kidney transplants, those with medical comorbid conditions had significantly lower Verbal Ability and Full Scale IQ scores. Earlier age of dialysis onset and a longer total time on dialysis (>9 months) were associated with lower test scores. Age-standardized duration of hospitalization was inversely correlated with IQ (r = -0.46, p <0.01) and was an independent significant predictor (Beta = -0.38, p = 0.02) of IQ scores in transplanted children.
Conclusions:
Child kidney transplant recipients have neurocognitive function impairments that are associated with markers of socioeconomic status (SES) and factors related to disease severity.
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