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Updated: Jul 4, 2025
Robot-Assisted Kidney Transplantation
Published on: July 19, 2021
Neurodevelopmental profile of infants and toddlers awaiting a kidney transplant
Danielle Glad1, Christopher Anzalone1, Finola Kane-Grade1
1Division of Clinical Behavioral Neuroscience, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, USA.
Insights
Infants and toddlers with kidney failure experience developmental delays, particularly in cognition and motor skills. Dialysis further impacts these areas, independent of other health conditions, highlighting the need for early intervention.
Area of Science:
- Pediatric Nephrology
- Neurodevelopmental Pediatrics
- Developmental Psychology
Background:
- Infants and toddlers with kidney failure face heightened risks of neurodevelopmental delays due to medical issues and rapid early brain development.
- Limited research exists on the long-term neuropsychological outcomes for this vulnerable pediatric population.
Purpose of the Study:
- To evaluate the neurodevelopmental functioning of infants and toddlers with kidney failure.
- To identify factors associated with developmental outcomes in this cohort.
Main Methods:
- Retrospective study of 23 infants/toddlers with kidney failure undergoing pretransplant evaluation (2010-2022).
- Utilized Bayley Scales of Infant and Toddler Development (3rd/4th Editions) for cognitive, language, and motor assessments.
- Statistical analyses included t-tests, linear models, and Pearson correlations to examine relationships between variables.
Main Results:
- Participants demonstrated below-average scores in cognitive, language, and motor domains.
- Patients on dialysis showed significantly lower cognitive and motor scores compared to those not on dialysis, even after adjusting for prematurity and epilepsy.
- Pretransplant cognitive and language scores positively correlated with posttransplant cognitive measures (Full-Scale IQ, verbal comprehension, fluid reasoning).
- Seven of 16 participants over age 5 were diagnosed with neurodevelopmental disorders, including three with autism spectrum disorder.
Conclusions:
- Infants and toddlers with kidney failure are at significant risk for developmental delays and subsequent neurodevelopmental disorders.
- Dialysis is independently associated with poorer cognitive and motor development in this population.
- Early neurodevelopmental assessment and intervention are crucial for children with kidney failure.
Background:
Infants and toddlers with kidney failure are susceptible to neurodevelopmental delays due to medical comorbidities and rapid brain development in early childhood. However, research on the neuropsychological development of this patient population has been limited over the past 10 years.
Methods:
We performed a retrospective study to evaluate the neurodevelopmental functioning of infants/toddlers with kidney failure who completed the Bayley Scales of Infant and Toddler Development (3rd and 4th Edition) as part of a pretransplant evaluation between 2010 and 2022 (n = 23; Mage = 18 months, SD = 8.53; 16 males) using t-tests, linear model, and Pearson correlations.
Results:
Mean Bayley scores of participants were below normative means for cognition (M = 86.74, 95% CI = 80.53-92.94, p < 0.001), language (M = 79.20, 95% CI = 73.32-85.08, p < 0.001), and motor (M = 78.00, 95% CI = 70.15-85.85, p < 0.001) domains. After adjusting for prematurity and epilepsy, patients on dialysis had significantly lower cognitive (78.7 vs. 93.8; p = 0.001) and motor scores (67.1 vs. 85.5; p = 0.01) compared to no dialysis. Pretransplant cognitive scores were positively correlated with posttransplant Full-Scale IQ (r(8) = 0.65 p = 0.04), verbal comprehension (r(8) = 0.75 p = 0.02), and fluid reasoning (r(7) = 0.68 p = 0.045). Similarly, pretransplant language scores were positively correlated with posttransplant Full-Scale IQ (r(7) = 0.74 p = 0.03) and verbal comprehension (r(7) = 0.73 p = 0.03). Of the 16 participants who reached age > 5 years during the study period, seven were diagnosed with a neurodevelopmental disorder, including three with autism spectrum disorder.
Conclusions:
Infants and toddlers with kidney failure are at risk of developmental delays and later neurodevelopmental disorders. Dialysis is associated with cognitive and motor delays independent of prematurity and epilepsy.
