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Published on: June 16, 2014
Assessment of cognitive functions and adaptive behavior in children with end-stage renal disease on regular
Azza Kamal Al Shahawy1, Mohamed Abdelaziz El-Gamasy1, Mohammed Abd Elhakeem Seleem2
1Department of Pediatrics, Faculty of Medicine, Tanta University, Tanta, Gharbia Governate, Egypt.
Insights
Children with end-stage renal disease (ESRD) undergoing hemodialysis (HD) show significantly lower intelligence quotient (IQ), adaptive behaviors, and executive functions compared to healthy peers. This highlights neurocognitive challenges in pediatric ESRD patients on HD.
Area of Science:
- Pediatric Nephrology
- Neuropsychology
- Developmental Pediatrics
Background:
- Chronic kidney disease (CKD) affects children, with potential for kidney damage lasting over three months.
- End-stage renal disease (ESRD) necessitates treatments like hemodialysis (HD) to filter blood when kidneys fail.
- Previous research indicates neurocognitive impairments in children with CKD.
Purpose of the Study:
- To evaluate cognitive functions in children with ESRD undergoing regular hemodialysis.
- To assess adaptive behavior in pediatric patients with ESRD on hemodialysis.
- To compare neurocognitive outcomes between children with ESRD and healthy controls.
Main Methods:
- A case-controlled study involving 30 children with ESRD on HD and 30 healthy controls.
- Utilized the Stanford Binet test (5th ed.) for intelligence quotient (IQ) assessment.
- Employed the Vineland test for adaptive behavior and the Wisconsin Card Sorting Test for executive functions.
Main Results:
- Children with ESRD on HD exhibited significantly lower mean IQ scores compared to the control group.
- Patients with ESRD demonstrated notably lower scores on adaptive behavior assessments (Vineland test).
- Executive functions, assessed via the Wisconsin Card Sorting Test, were also significantly impaired in the ESRD group.
Conclusions:
- Pediatric patients with ESRD on hemodialysis experience deficits in IQ, adaptive behavior, and executive functions.
- These findings underscore the impact of ESRD and HD on neurocognitive development in children.
- Further research and interventions are warranted to address cognitive challenges in pediatric ESRD.
Abstract:
Chronic kidney disease (CKD) is defined by the Kidney Disease and Outcome Quality Initiative as a child who has kidney damage lasting for at least three months with or without decreased glomerular filtration rate. Hemodialysis (HD) means removal of waste products and extra fluid directly from the blood when the kidneys do not work properly. Studies aimed at investigating neurocognitive impairment in children with CKD have identified a wide range of delays in cognitive development. The aim of this study was to assess the cognitive functions and adaptive behavior in children with end-stage renal disease (ESRD) on regular HD. This case-controlled study was conducted on 30 children suffering from ESRD who were on treatment at the Pediatric Nephrology Unit of Tanta University Hospital. Thirty apparently healthy children served as a control group, in the period from January 2017 to January 2018. All children were subjected to full history taking, careful physical and neurological examination, specific investigations including assessment of intelligence quotient (IQ) using Stanford Binet test 5th edition; assessment of adaptive behavior, assessment of executive functions by using Wisconsin Card Sorting Test; and continuous performance test. This study showed that mean values of IQ and the Vineland test were significantly lower among patients than controls. The study suggests that children with ESRD had lower IQ, adaptive behavior and executive functions than healthy control children.
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