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Updated: Oct 15, 2025
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Prevalence of cognitive dysfunction and its risk factors in children with chronic kidney disease in a developing
Elawin Viriyapak1, Sasitorn Chantaratin2, Kanokwan Sommai1
1Department of Pediatrics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Insights
Cognitive dysfunction is common in children with chronic kidney disease (CKD). Socioeconomic factors like school attendance and family income significantly impact cognitive function in these children.
Area of Science:
- Pediatric Nephrology
- Neuropsychology
- Global Health
Background:
- Chronic kidney disease (CKD) is linked to cognitive dysfunction.
- Cognitive function in pediatric CKD patients in developing nations remains under-researched.
Purpose of the Study:
- To investigate cognitive function in children with CKD in a developing country.
- To identify factors associated with cognitive dysfunction in this population.
Main Methods:
- Cross-sectional study of children aged 6-18 with CKD stages 2-5D and kidney transplant recipients.
- Cognitive function assessed using WISC-V (6-16 years) and WAIS-III (17-18 years).
- Multivariable regression analysis to identify associated factors.
Main Results:
- 64.8% of 37 children had below-average cognitive function (FSIQ <90); 24.3% had cognitive impairment (FSIQ <70).
- Kidney replacement therapy and low family income were associated with below-average cognitive function.
- School dropout and low family income significantly correlated with poorer cognitive function.
Conclusions:
- Cognitive dysfunction is prevalent in pediatric CKD.
- Socioeconomic factors, including school attendance and family income, are key determinants of cognitive outcomes.
- Recommend cognitive screening for CKD children with socioeconomic risk factors.
Background:
Chronic kidney disease (CKD) is associated with cognitive dysfunction. Cognitive function in children with CKD residing in developing countries has not been previously reported.
Methods:
This cross-sectional study included children aged 6-18 years with CKD stages 2-5D and kidney transplant. Cognitive function was assessed by WISC-V for children from 6-16 years of age. In adolescents 17-18 years of age, WAIS-III was used. Factors associated with cognitive dysfunction were identified using multivariable regression analysis.
Results:
Thirty-seven children with median age 13.9 (11.3-15.7) years were recruited. The median full-scale intelligence quotient (FSIQ) was 83.0 (71.0-95.0). Below-average cognitive function (FSIQ <90) was identified in 24 children (64.8%), 24.3% of whom had cognitive impairment (FSIQ <70). Most children (94.6%) scored lower than average on at least 1 cognitive domain. Kidney replacement therapy (p = 0.03) and low family income (p = 0.02) were associated with below-average cognitive function in multivariable logistic regression analysis. Children who left school and low family income were significantly associated with cognitive function. The FSIQ of children who had left school was 12.94 points lower than the educated group (p = 0.046). In addition, every 10,000 Thai Baht (approximately 330 United States dollars) increase in family income correlated with 1.58 increase in FSIQ (p = 0.047).
Conclusion:
Cognitive dysfunction was commonly found in children with CKD. Socioeconomic factors, particularly school attendance and family income, were associated with cognitive dysfunction. Cognitive evaluation is suggested for children with CKD who have socioeconomic risk factors. "A higher resolution version of the Graphical abstract is available as Supplementary information."
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