Jillian Popel1, Rachel Joffe1, Bryan V Acton2, Gwen Y Bond3, Ari R Joffe1, Julian Midgley4, Charlene M T Robertson1,5, Reg S Sauve6,7, Catherine J Morgan8. 1. Department of Pediatrics, Edmonton Clinic Health Academy, University of Alberta, 11405 - 87 Ave, Edmonton, AB, T6G 1C9, Canada. 2. Royal University Hospital, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK, S7N 0W8, Canada. 3. Stollery Children's Hospital, University of Alberta, 8440 112 St NW, Edmonton, AB, T6G 2B7, Canada. 4. Division of Pediatric Nephrology, Department of Pediatrics, Cumming School of Medicine, University of Calgary, 3330 Hospital Dr. NW, Calgary, AB, T2N 4N1, Canada. 5. Glenrose Rehabilitation Hospital, 10230 111 Avenue Northwest, Edmonton, AB, T5G 0B7, Canada. 6. Alberta Children's Hospital, 2888 Shaganappi Trail NW, Calgary, AB, T3B 6A8, Canada. 7. Department of Pediatrics, University of Calgary, 2500 University Dr NW, Calgary, AB, T2N 1N4, Canada. 8. Department of Pediatrics, Edmonton Clinic Health Academy, University of Alberta, 11405 - 87 Ave, Edmonton, AB, T6G 1C9, Canada. cmorgan@ualberta.ca.
Abstract
BACKGROUND: Clinicians often use information about developmental outcomes in decision-making around offering complex, life-saving interventions in children such as dialysis and renal transplant. This information in children with end-stage renal disease (ESRD) is limited, particularly when ESRD onset is in infancy or early childhood. METHODS: Using data from an ongoing prospective, longitudinal, inception cohort study of children with renal transplant before 5 years of age, we evaluated (1) the risk of adverse neurocognitive and functional outcomes at 5 years of age and (2) predictors of developmental outcomes. RESULTS: We found evidence of neurocognitive sequelae of ESRD in very young children; however, developmental outcomes appear remarkably better when compared with findings of two or three decades ago. Less time on dialysis predicted higher developmental scores, and hemodialysis was associated with poorer developmental outcomes. CONCLUSIONS: Our data suggest that renal replacement therapies in young children are associated with acceptable developmental outcome. Programs to identify those with developmental delays and provide early intervention may allow achievement of the child's full potential.
BACKGROUND: Clinicians often use information about developmental outcomes in decision-making around offering complex, life-saving interventions in children such as dialysis and renal transplant. This information in children with end-stage renal disease (ESRD) is limited, particularly when ESRD onset is in infancy or early childhood. METHODS: Using data from an ongoing prospective, longitudinal, inception cohort study of children with renal transplant before 5 years of age, we evaluated (1) the risk of adverse neurocognitive and functional outcomes at 5 years of age and (2) predictors of developmental outcomes. RESULTS: We found evidence of neurocognitive sequelae of ESRD in very young children; however, developmental outcomes appear remarkably better when compared with findings of two or three decades ago. Less time on dialysis predicted higher developmental scores, and hemodialysis was associated with poorer developmental outcomes. CONCLUSIONS: Our data suggest that renal replacement therapies in young children are associated with acceptable developmental outcome. Programs to identify those with developmental delays and provide early intervention may allow achievement of the child's full potential.
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Authors: John F S Crocker; Philip D Acott; James E J Carter; David S Lirenman; G Wayne MacDonald; Mona McAllister; Mary Catherine McDonnell; Sarah Shea; Harry N Bawden Journal: Pediatr Nephrol Date: 2002-09-25 Impact factor: 3.714
Authors: Divya G Moodalbail; Kathryn A Reiser; John A Detre; Robert T Schultz; John D Herrington; Christos Davatzikos; Jimit J Doshi; Guray Erus; Hua-Shan Liu; Jerilynn Radcliffe; Susan L Furth; Stephen R Hooper Journal: Clin J Am Soc Nephrol Date: 2013-05-30 Impact factor: 8.237
Authors: Charlene M T Robertson; Reg S Sauve; Ari R Joffe; Gwen Y Alton; Diane M Moddemann; Patricia M Blakley; Anne R Synnes; Irina A Dinu; Joyce R Harder; Reeni Soni; Jaya P Bodani; Ashok P Kakadekar; John D Dyck; Derek G Human; David B Ross; Ivan M Rebeyka Journal: Cardiol Res Pract Date: 2011-05-08 Impact factor: 1.866