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Cognitive functioning and school performance in children with renal failure

K W Lawry¹, B H Brouhard, R J Cunningham

¹Department of Pediatrics, Cleveland Clinic Foundation, Ohio 44195.

Pediatric Nephrology (Berlin, Germany)

|June 1, 1994

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Children with end-stage renal disease show improved academic achievement, particularly in written language and English, after kidney transplantation compared to dialysis. Transplant patients performed at or above age and grade level, unlike dialysis patients.

Area of Science:

Pediatric Nephrology
Neuropsychology
Educational Psychology

Background:

Previous research indicates neuropsychological deficits in children with end-stage renal disease (ESRD).
Limited studies compare cognitive and academic outcomes between ESRD patients on dialysis versus those who have undergone renal transplantation.

Purpose of the Study:

To evaluate the impact of chronic renal failure on cognitive functioning and school performance in children and adolescents.
To compare cognitive and academic outcomes in pediatric patients undergoing dialysis versus those post-renal transplantation.

Main Methods:

Standardized IQ and achievement tests (Woodcock-Johnson) were administered to assess cognitive abilities.
Academic performance was measured using semester grades and calculating a Grade Point Average (GPA).

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Participants included 11 dialysis patients and 13 transplant patients, comparable in demographics.

Main Results:

No significant differences in overall IQ or subtest scores were found between dialysis and transplant groups.
Transplant patients demonstrated superior performance on written language achievement tests (P=0.04) and English schoolwork (P<0.05).
Dialysis patients generally performed below age and grade level, while transplant patients performed at or above these levels.

Conclusions:

Renal transplantation appears to positively influence academic achievement, especially in written language and English, compared to dialysis.
Significant differences in age-equivalent scores for mathematics and written language were observed between the groups.
While academic performance in English and written language improved post-transplant, overall GPA and mathematics GPA showed no significant differences.