Risk factors for neurocognitive impairment and the relation with structural brain abnormality in children and young adults with severe chronic kidney disease

Autor: Sophie Lijdsman, Kim J. Oostrom, Marit S. van Sandwijk, Antonia H. Bouts, Koen van Hoeck, Huib de Jong, Jaap Oosterlaan, Frederike J. Bemelman, Marsh Königs, Jaap W. Groothoff
Přispěvatelé: Pediatrics, Graduate School, Child and Adolescent Psychiatry & Psychosocial Care, APH - Mental Health, APH - Methodology, CCA - Cancer Treatment and Quality of Life, APH - Quality of Care, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, ARD - Amsterdam Reproduction and Development, APH - Personalized Medicine, Nephrology, Paediatric Nephrology, General Paediatrics, Paediatric Pulmonology
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Pediatric Nephrology, 38(6), 1957-1969. Springer-Verlag
Pediatric nephrology (Berlin, Germany). Springer Verlag
Pediatric nephrology
Lijdsman, S, Oostrom, K J, van Sandwijk, M S, Bouts, A H, van Hoeck, K, de Jong, H, Oosterlaan, J, Bemelman, F J, Königs, M & Groothoff, J W 2022, ' Risk factors for neurocognitive impairment and the relation with structural brain abnormality in children and young adults with severe chronic kidney disease ', Pediatric Nephrology . https://doi.org/10.1007/s00467-022-05781-1
Pediatric Nephrology. Springer Verlag
ISSN: 0931-041X
DOI: 10.1007/s00467-022-05781-1
Popis: Background Severe chronic kidney disease (CKD) in children and young adults has shown to be associated with abnormal brain development, which may contribute to neurocognitive impairments. We aimed to investigate risk factors for neurocognitive impairment and investigate the relation with structural brain abnormalities in young severe CKD patients. Methods This cross-sectional study includes 28 patients with severe CKD (eGFR n = 8], dialysis [n = 8], transplanted [n = 12]). We assessed neurocognitive functioning using a comprehensive test battery and brain structure by magnetic resonance imaging metrics of brain volume and white matter integrity (fractional anisotropy [FA] and mean diffusivity [MD] measured with diffusion tensor imaging). Multivariate regression and mediation analyses were performed between clinical CKD parameters, brain structure, and neurocognitive outcome. Results A combination of risk factors (e.g., longer time since kidney transplantation, longer dialysis duration and late CKD onset) was significantly associated with lower intelligence and/or worse processing speed and working memory. Lower FA in a cluster of white matter tracts was associated with lower intelligence and mediated the relation between clinical risk factors and lower intelligence. Conclusions Young severe CKD patients with a prolonged duration of kidney replacement therapy, either dialysis or transplantation are at particular risk for impairments in intelligence, processing speed, and working memory. Disrupted white matter integrity may importantly contribute to these neurocognitive impairments. Prospective, longitudinal studies are needed to elucidate the mechanisms involved in CKD and treatment that affect white matter integrity and neurocognitive outcome in young patients. Graphical abstract
Databáze: OpenAIRE
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