Neurodevelopmental outcomes in children with chronic kidney disease: a scoping review

Chronic kidney disease (CKD) exhibits unique clinical characteristics in the pediatric population, including growth disturbances and alterations in neurocognitive development. Given the complexity of this condition, it is imperative to adopt comprehensive care strategies that not only address the primary pathology but also mitigate the developmental challenges associated with the disease.

The objective was to map and synthesize current scientific evidence regarding the association between CKD and neurodevelopmental outcomes in childhood.

A scoping review was performed using electronic databases -Virtual Health Library (VHL), Medline via PubMed, Scopus, Embase, and Web of Science - to identify studies published between 2014 and 2024. The search strategy utilized a combination of the descriptors "Child Development" AND "Renal Insufficiency, Chronic" to identify relevant studies. The findings were subsequently summarized and qualitatively synthesized.

Of the 2,957 studies identified (2,941 through database searches and 16 through manual searching), 19 specifically examined the implications of CKD on child development and were included in this review. Evidence suggests that children with CKD experience alterations in brain structure and function, including reduced brain volume and compromised structural integrity. These neurological changes appear to be associated with poorer outcomes in both cognitive and motor domains.

CKD has systemic and complex effects on the pediatric population, directly impacting neurodevelopment. These findings underscore the importance of early, multidisciplinary strategies to monitor and support neurodevelopment in children with CKD.