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Intellectual output of children with chronic renal failure on continuous ambulatory peritoneal dialysis
R M Jaramillo-Solorio1, L Menodoza-Guevara, E Garcia-Lopez
1Department of Pediatric Nephrology, Hospital de Pediatria, Centro Medico Nacional Siglo XXI, Mexico City, Mexico.
Insights
Pediatric patients on continuous ambulatory peritoneal dialysis (CAPD) generally maintain average intelligence quotients, despite some challenges with performance-based tasks. Child plasticity aids in coping with uremia and neurological alterations.
Area of Science:
- Pediatric Nephrology
- Neuropsychology
- Child Development
Background:
- Continuous ambulatory peritoneal dialysis (CAPD) is a treatment for pediatric kidney failure.
- Understanding the cognitive impact of chronic illness in children is crucial for holistic care.
Purpose of the Study:
- To quantify intelligence quotient (IQ) in children undergoing CAPD.
- To assess cognitive function and identify potential neurological damage in this population.
Main Methods:
- Utilized the Wechsler test to evaluate global IQ in 30 children (ages 8-18).
- Administered the Bender test to screen for brain damage.
- Analyzed verbal and performance IQ scores, considering factors like illness chronicity and blood urea nitrogen levels.
Main Results:
- Most children (76.7%) exhibited average IQ; some fell into dull normal, mild retardation, or borderline categories.
- Bender test results did not correlate with brain damage.
- While verbal IQ was high, 34% of children scored low on performance IQ, suggesting difficulties with specific cognitive tasks.
Conclusions:
- Childhood plasticity is a key factor in adapting to uremia and its associated neurological alterations.
- Cognitive capacity, or IQ, reflects a child's ability to utilize resources to manage their environment.
- Even with neurological changes, plasticity helps children maintain good global IQ during CAPD treatment, prior to transplantation.
Abstract:
The aim of this study is to quantify the intelligence output in our pediatric population on continuous ambulatory peritoneal dialysis (CAPD) treatment. A total of 30 children were studied, with an age range of eight to 18 years. For evaluating a global intelligence quotient (IQ), the Wechsler test was applied according to their age. And, as a complement, a Bender test was also requested to deny or confirm brain damage. The Wechsler test showed an average intelligence quotient in most of the children (76.7%); a small group (16.7%) was classified as dull normal, 1 child had mild retardation, and 1 was borderline. All of them had a Bender test that did not correlate with brain damage. Most of them maintained a very high verbal IQ, but, when the performance IQ was qualified, 34% got a low score, and a certain difficulty in solving this part of the test was observed. Maybe this was influenced by chronicity of the sickness and/or the blood urea nitrogen level. In conclusion, the child's plasticity is his best quality to cope with uremia and the alterations caused by it. Therefore the idea is to consider the intelligence quotient as the capacity that the subjects have to use their own resources to cope with their environment. And, even though the neurological alterations exist, the child's plasticity helps him/her maintain a good global intelligence quotient, even though he/she is not having immediate transplantation.