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Neurodevelopmental Outcomes in Early Childhood Chronic Kidney Disease: Evidence from a Case-control Study
Sahil Vikas1, Rajni Sharma1, Lokesh Saini2
1Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Insights
Chronic kidney disease (CKD) in children significantly impairs neurocognitive development, with outcomes worsening as the disease progresses. Early intervention is crucial for affected children.
Area of Science:
- Pediatric Nephrology
- Neurodevelopmental Pediatrics
- Child Health
Background:
- Children with chronic kidney disease (CKD) face risks of impaired neurocognitive outcomes.
- The rapid brain development in early childhood makes this period critical for assessing CKD's impact.
Purpose of the Study:
- To investigate the impact of chronic kidney disease (CKD) on neurocognition in early childhood.
- To identify disease-associated risk factors affecting neurocognitive development in pediatric CKD patients.
Main Methods:
- A cross-sectional case-control study involved 52 children with CKD (Stage 3-5) and 52 age-matched controls.
- Neurocognitive outcomes were assessed using the Developmental Assessment Scales for Indian Infants (DASII).
- Statistical analyses were performed to evaluate differences between groups.
Main Results:
- Children with CKD demonstrated significantly lower scores in mental functions, motor functions, and developmental quotient compared to controls.
- Neurocognitive function declined progressively with CKD stage, with Stage 5 patients exhibiting the lowest scores.
- Significant differences in weight, height, head circumference, and certain blood parameters (Hb, MCH, MCHC) were observed across CKD stages.
Conclusions:
- Chronic kidney disease (CKD) is a serious condition affecting pediatric health and development.
- Progressive decline in neurocognitive outcomes correlates with advancing CKD stages, negatively impacting overall child development.
Background:
Children with chronic kidney disease (CKD) are at risk of inferior neurocognitive outcomes. As the brain develops rapidly during the early years of life, we wanted to find out the impact of CKD on neurocognition when it occurs during this time and any disease-associated risk factors.
Methods:
A cross-sectional case-control study was conducted in the Paediatric Nephrology Clinic, PGIMER, Chandigarh. After obtaining parental consent, 52 children with CKD Stage 3-5 and 52 age-matched case controls were enrolled in the study. Neurocognitive outcome was assessed by the Developmental Assessment Scales for Indian Infants (DASII). Proper statistical tests were used to analyse the data.
Results:
Mean comparison revealed that CKD children performed significantly lower on mental functions, motor functions and developmental quotient of DASII. Neurocognitive functions declined with disease progression, with children of CKD Stage 5 scoring lowest. Further, there was a significant difference in weight, height/length and head circumference between those in Stage 3 and 5. Similarly, there are significant mean differences in Hb, MCH, and MCHC levels between Stage 3 and both Stage 4 and 5, but no significant difference between those in Stage 4 and 5.
Conclusion:
CKD is a debilitating condition that can have a significant impact on the health and development of children. Neurocognitive outcome declines as the stage of CKD progresses, which worsens their overall outcomes.
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