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Long-term neurocognitive outcomes of patients with end-stage renal disease during infancy

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Abstract

Background

End-stage renal disease (ESRD) during infancy has been associated with poor short-term neurocognitive outcomes. Limited information exists regarding long-term outcomes.

Methods

Neurocognitive outcomes for 12 patients diagnosed with ESRD during the first 16 months of life were assessed. Nine patients (mean age: 11 years) were compared to their healthy siblings (mean age: 10 years) on measures of intellectual and executive functioning, memory, and academic achievement using paired-samples t tests.

Results

Patients’ Full Scale IQ (FSIQ) scores (M = 78, SD = 16.1) were significantly lower than sibling controls (M = 94, SD = 18.9; p < 0.03). For patients, FSIQ negatively correlated with total months on dialysis (r = −0.6, p < 0.04), as did WISC-IV Processing Speed (r = −0.6, p < 0.05). Patients’ scores on the Metacognition Index of the BRIEF (M = 61.4, SD = 16.3) were significantly higher (indicating greater risk for dysfunction) than siblings (M = 46.7, SD = 6.4; p < 0.04). Patients’ scores (M = 84, SD = 19) on the WIAT-II-A Total Achievement were significantly lower than siblings (M = 103, SD = 20, p < 0.01). Younger age at transplant was associated with higher scores on measures of Processing Speed (r = −0.7, p < 0.05), as well as higher scores on measures of executive functioning, memory, and academic achievement.

Conclusions

In summary, patients diagnosed with ESRD as infants had intellectual and metacognitive functioning significantly lower than sibling controls. Fewer months on dialysis and younger age at transplant were associated with better outcomes.

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Acknowledgments

This study was supported in part by a Katharine B. Richardson Endowment Award from Children’s Mercy Hospitals and Clinics. The authors would like to thank Brenda Brewer, Yelena Wu, and Brandon Aylward for their assistance with this study. We would also like to acknowledge the patients and families who participated in this research.

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Authors and Affiliations

  1. Developmental & Behavioral Sciences, Children’s Mercy Hospitals and Clinics, 2401 Gillham Road, Kansas City, MO, 64113, USA

    Rebecca J. Johnson

  2. Nephrology, Children’s Mercy Hospitals and Clinics, 2401 Gillham Road, Kansas City, MO, 64113, USA

    Bradley A. Warady

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  1. Rebecca J. Johnson
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  2. Bradley A. Warady
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Correspondence to Rebecca J. Johnson.

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Johnson, R.J., Warady, B.A. Long-term neurocognitive outcomes of patients with end-stage renal disease during infancy. Pediatr Nephrol 28, 1283–1291 (2013). https://doi.org/10.1007/s00467-013-2458-z

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  • DOI: https://doi.org/10.1007/s00467-013-2458-z

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