Marta Molnar-Varga1,2, Marta Novak3,4, Attila J Szabo5,6, Kata Kelen5, Elani Streja7, Adam Remport8, Istvan Mucsi3,9, Miklos Z Molnar10, Gyorgy Reusz5,6. 1. Institute for the Psychology of Special Needs, Faculty of Special Education, ELTE University, Budapest, Hungary. marta.molnar@barczi.elte.hu. 2. Special Education Institute of Atypical Behaviour and Cognition, Faculty of Special Education, ELTE University, Ecseri Street 3, 1097, Budapest, Hungary. marta.molnar@barczi.elte.hu. 3. Institute of Behavioral Sciences, Semmelweis University, Budapest, Hungary. 4. Department of Psychiatry, University Health Network, University of Toronto, Toronto, Canada. 5. First Department of Pediatrics, Semmelweis University, Budapest, Hungary. 6. MTA-SE, Pediatrics and Nephrology Research Group, Budapest, Hungary. 7. Division of Nephrology, University of California, Irvine, CA, USA. 8. Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary. 9. Division of Nephrology, University Health Network, University of Toronto, Toronto, Canada. 10. Division of Nephrology, Department of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA.
Abstract
BACKGROUND: End-stage renal disease (ESRD) in children is associated with impaired neurocognitive function and development. However, data on factors associated with neurocognitive dysfunctions in children with kidney transplants are limited. METHODS: We conducted a cross-sectional analysis comparing cognitive functions (using the Woodcock-Johnson International Edition, WJIE) in 35 kidney transplant and 35 healthy control children. Data on laboratory measurements, comorbidities, and social characteristics were collected. RESULTS: Transplant children had significantly worse scores on the intelligence quotient (IQ) test compared with controls [Full Scale IQ score 85 (26) vs 107 (10), p <0.001]. Lower maternal education level was significantly associated with lower WJIE cognitive test scores; however, no association was found between laboratory values and WJIE scores. Among children with kidney transplants, those with medical comorbid conditions had significantly lower Verbal Ability and Full Scale IQ scores. Earlier age of dialysis onset and a longer total time on dialysis (>9 months) were associated with lower test scores. Age-standardized duration of hospitalization was inversely correlated with IQ (r = -0.46, p <0.01) and was an independent significant predictor (Beta = -0.38, p = 0.02) of IQ scores in transplanted children. CONCLUSIONS: Child kidney transplant recipients have neurocognitive function impairments that are associated with markers of socioeconomic status (SES) and factors related to disease severity.
BACKGROUND: End-stage renal disease (ESRD) in children is associated with impaired neurocognitive function and development. However, data on factors associated with neurocognitive dysfunctions in children with kidney transplants are limited. METHODS: We conducted a cross-sectional analysis comparing cognitive functions (using the Woodcock-Johnson International Edition, WJIE) in 35 kidney transplant and 35 healthy control children. Data on laboratory measurements, comorbidities, and social characteristics were collected. RESULTS: Transplant children had significantly worse scores on the intelligence quotient (IQ) test compared with controls [Full Scale IQ score 85 (26) vs 107 (10), p <0.001]. Lower maternal education level was significantly associated with lower WJIE cognitive test scores; however, no association was found between laboratory values and WJIE scores. Among children with kidney transplants, those with medical comorbid conditions had significantly lower Verbal Ability and Full Scale IQ scores. Earlier age of dialysis onset and a longer total time on dialysis (>9 months) were associated with lower test scores. Age-standardized duration of hospitalization was inversely correlated with IQ (r = -0.46, p <0.01) and was an independent significant predictor (Beta = -0.38, p = 0.02) of IQ scores in transplanted children. CONCLUSIONS:Child kidney transplant recipients have neurocognitive function impairments that are associated with markers of socioeconomic status (SES) and factors related to disease severity.
Authors: K Gulleroglu; E Baskin; U S Bayrakci; M Aydogan; F Alehan; A Kantar; F Karakayali; G Moray; M Haberal Journal: Transplant Proc Date: 2013 Impact factor: 1.066
Authors: Debbie S Gipson; Stephen R Hooper; Peter J Duquette; Crista E Wetherington; Kurt K Stellwagen; Tonya L Jenkins; Maria E Ferris Journal: Child Neuropsychol Date: 2006-12 Impact factor: 2.500
Authors: Arlene C Gerson; Alicia Wentz; Allison G Abraham; Susan R Mendley; Stephen R Hooper; Robert W Butler; Debbie S Gipson; Marc B Lande; Shlomo Shinnar; Marva M Moxey-Mims; Bradley A Warady; Susan L Furth Journal: Pediatrics Date: 2010-01-18 Impact factor: 7.124