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Genomic Disorders and Neurocognitive Impairment in Pediatric CKD

Miguel Verbitsky1, Amy J Kogon2, Matthew Matheson3

  • 1Division of Nephrology, College of Physicians and Surgeons, Columbia University, New York, New York.

Journal of the American Society of Nephrology : JASN
|March 29, 2017
PubMed

Insights

Children with chronic kidney disease (CKD) and genomic disorders show poorer neurocognitive performance. Early identification of these genetic conditions may enable personalized interventions for better outcomes.

Area of Science:

  • Pediatric Nephrology
  • Neurodevelopmental Disorders
  • Genetics

Background:

  • Children with chronic kidney disease (CKD) face increased risks for neurocognitive impairment.
  • The exact causes of neurocognitive dysfunction in pediatric CKD are not fully understood.
  • Genomic disorders may contribute to both organ malformations and neurocognitive deficits in children.

Purpose of the Study:

  • To investigate neurocognitive performance in pediatric CKD patients with and without genomic disorders.
  • To determine if genomic disorders are associated with impaired neurocognitive function at study enrollment.

Main Methods:

  • Analysis of data from the Chronic Kidney Disease in Children (CKiD) Study.
  • Comparison of neurocognitive assessments between children with genomic disorders (n=31) and non-carriers (n=389).
  • Statistical analysis controlling for factors like birth weight, maternal education, and ancestry.

Main Results:

  • Children with genomic disorders scored significantly lower on intelligence, anxiety/depressive symptoms, and executive function measures (0.6-0.7 SD difference).
  • These cognitive deficits persisted after adjusting for known confounding factors.
  • Higher maternal education attenuated the negative impact of genomic disorders on neurocognitive function.

Conclusions:

  • Impaired neurocognitive function in some children with CKD may stem from genetic lesions affecting both kidney and brain development.
  • Early identification of genomic disorders in pediatric CKD is crucial for timely diagnosis and personalized interventions.
  • Genetic and environmental factors, such as maternal education, can modify the neurocognitive outcomes in these children.

Keywords:
Epidemiology and outcomeschronic kidney diseasehuman geneticspediatric nephrology

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