Age-Related Changes in Brain Structure in Pediatric Chronic Kidney Disease

Area of Science:

• Pediatric Nephrology
• Neuroscience
• Developmental Biology

Background:

• Pediatric patients with chronic kidney disease (CKD) exhibit reduced cerebellum volume, associated with neurocognitive deficits and lower estimated glomerular filtration rate (eGFR).
• These age-related brain changes in CKD patients have not been thoroughly examined during childhood and early adulthood.

Purpose of the Study:

• To evaluate age-related neurodevelopmental differences in pediatric CKD patients compared to controls.
• To investigate associations between regional neuroanatomy, functional outcomes, and disease-related variables in children with CKD.

Main Methods:

• A case-control study involving 124 individuals (ages 6-21) with and without CKD.
• Utilized neurocognitive testing and 3-Tesla magnetic resonance imaging (MRI) for quantitative neuroanatomical scans.
• Analyzed brain region volumes and assessed differences using multivariable linear models, including age-group interactions.

Main Results:

• CKD patients scored lower on neurocognitive measures compared to controls.
• The CKD group demonstrated differential age-related changes in cerebellar gray and white matter volumes.
• Reduced cerebellar gray matter volume correlated positively with eGFR in CKD patients and was associated with executive function deficits.

Conclusions:

• Pediatric CKD is associated with distinct age-related neurodevelopmental trajectories compared to healthy peers.
• Cerebellar volume reductions in children with CKD are linked to cognitive impairments and kidney function.
• Monitoring neurodevelopment and implementing early interventions are vital for mitigating cognitive deficits in pediatric CKD.