Differential Attention Functioning in Pediatric Chronic Kidney Disease
Peter J Duquette1, Debbie S Gipson2, Stephen R Hooper3
1Department of Physical Medicine and Rehabilitation, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
Insights
Children with chronic kidney disease (CKD) exhibit specific attention deficits compared to typically developing peers. These attention problems, particularly in executive functions, are more pronounced with increased disease severity.
Area of Science:
- Pediatric Nephrology
- Neuropsychology
- Developmental Psychology
Background:
- Chronic kidney disease (CKD) affects multiple organ systems, potentially impacting cognitive functions.
- Attention is a complex cognitive process crucial for academic and daily functioning in children.
Purpose of the Study:
- To investigate specific attention functions in school-age children with CKD.
- To compare attention dimensions between children with CKD and a typically developing control group.
Main Methods:
- A cross-sectional study included 30 children with CKD (dialysis or conservative treatment) and 41 typically developing controls.
- Attention was assessed using measures aligned with Mirsky's multidimensional model, evaluating Focus/Execute, Sustain, Stability, Shift, and Encode.
- CKD patients were stratified into maintenance dialysis and mild/moderate conservative treatment groups.
Main Results:
- Children with CKD performed significantly worse than controls on Focus/Execute, Sustain, and Encode dimensions.
- A higher proportion of CKD children scored at-risk levels (≥1 SD below the mean) in Shift and Encode domains.
- Disease severity correlated with poorer attention function in the CKD group.
Conclusions:
- Children with CKD demonstrate specific vulnerabilities in multiple attention dimensions compared to peers.
- Subtle attention deficits may be present even in mild to moderate CKD.
- Attention impairments in CKD are linked to disease severity, highlighting the need for targeted interventions.
Objective:
To compare specific attention functions for school-age children with chronic kidney disease (CKD) to those of a typically developing control group.
Methods:
A cross-sectional study examined attention dimensions for children and adolescents with CKD (n = 30) in comparison to a typically developing control group (n = 41). The CKD group consisted of those receiving maintenance dialysis (n = 15) and those with mild/moderate CKD treated conservatively (n = 15). Measures aligning with Mirsky's conceptual multidimensional model of attention were selected to compare groups across five dimensions of attention: Focus/Execute, Sustain, Stability, Shift, and Encode.
Results:
Significant group differences were revealed, with the CKD group performing worse than controls on the Focus/Execute, Sustain, and Encode dimensions. The CKD group also had a larger proportion of children with scores one standard deviation or more below the mean on the Shift and Encode domains, suggesting an at-risk level of functioning in these dimensions. Secondary analyses showed disease severity to be correlated with worse attention functions for children with CKD.
Conclusion:
Children with CKD may be vulnerable to subtle, specific deficits in numerous attention dimensions relative to their typically developing peers, particularly for those with more severe disease.
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