Early pediatric chronic kidney disease is associated with brain volumetric gray matter abnormalities

Matthew A Solomon; Ellen van der Plas; Kathleen E Langbehn; Marci Novak; Jordan L Schultz; Timothy R Koscik; Amy L Conrad; Patrick D Brophy; Susan L Furth; Peggy C Nopoulos; Lyndsay A Harshman

doi:10.1038/s41390-020-01203-w

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Early pediatric chronic kidney disease is associated with brain volumetric gray matter abnormalities

Journal article

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Early pediatric chronic kidney disease is associated with brain volumetric gray matter abnormalities

Matthew A Solomon, Ellen van der Plas, Kathleen E Langbehn, Marci Novak, Jordan L Schultz, Timothy R Koscik, Amy L Conrad, Patrick D Brophy, Susan L Furth, Peggy C Nopoulos, …

Pediatric research, Vol.89(3), pp.526-532

02/2021

DOI: 10.1038/s41390-020-01203-w

PMCID: PMC7981243

PMID: 33069166

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https://www.ncbi.nlm.nih.gov/pmc/articles/7981243View

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Abstract

The impact of pediatric chronic kidney disease (pCKD) on the brain remains poorly defined. The objective of this study was to compare brain morphometry between children with early-stage pCKD and typically developing peers using structural magnetic resonance imaging (MRI).\nThe sample age range was 6-16 years. A total of 18 children with a diagnosis of pCKD (CKD stages 1-3) due to congenital anomalies of the kidney and urinary tract and 24 typically developing peers were included. Volumetric data from MRI and neurocognitive testing were compared using linear models including pCKD status, age, maternal education level, and socioeconomic status.\nCerebellar gray matter volume was significantly smaller in pCKD, t\n = -2.71, p = 0.01. In contrast, cerebral gray matter volume was increased in pCKD, t\n = 2.08, p = 0.04. Reduced cerebellum gray matter volume was associated with disease severity, operationalized as estimated glomerular filtration rate (eGFR), t\n = 2.21, p = 0.04 and predicted lower verbal fluency scores in the pCKD sample. Enlarged cerebral gray matter in the pCKD sample predicted lower scores on mathematics assessment.\nThis study provides preliminary evidence for a morphometric underpinning to the cognitive deficits observed in pCKD.\nThe impact of pediatric chronic kidney disease (CKD) on the brain remains poorly defined, with no data linking brain morphometry and observed cognitive deficits noted in this population. We explored the relationship between brain morphometry (using structural magnetic resonance imaging), cognition, and markers of CKD. Cerebellar and cerebral gray matter volumes are different in early CKD. Volumetric decreases in cerebellar gray matter are predicted by lower eGFR, suggesting a link between disease and brain morphometry. Reduced cerebellar gray matter predicted lower verbal fluency for those with pCKD. Enlarged cerebral gray matter in the pCKD sample predicted lower mathematics performance.

Details

Title: Subtitle: Early pediatric chronic kidney disease is associated with brain volumetric gray matter abnormalities
Creators: Matthew A Solomon - University of Iowa Stead Family Department of Pediatrics, Iowa City, IA, USA
Ellen van der Plas - Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, IA, USA
Kathleen E Langbehn - Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, IA, USA
Marci Novak - Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, IA, USA
Jordan L Schultz - University of Iowa College of Pharmacy, Iowa City, IA, USA
Timothy R Koscik - Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, IA, USA
Amy L Conrad - University of Iowa Carver College of Medicine, Iowa City, IA, USA
Patrick D Brophy - University of Rochester, Rochester, NY, USA
Susan L Furth - Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
Peggy C Nopoulos - Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, IA, USA
Lyndsay A Harshman - University of Iowa Stead Family Department of Pediatrics, Iowa City, IA, USA. lyndsay-harshman@uiowa.edu
Resource Type: Journal article
Publication Details: Pediatric research, Vol.89(3), pp.526-532
DOI: 10.1038/s41390-020-01203-w
PMID: 33069166
PMCID: PMC7981243
NLM abbreviation: Pediatr Res
ISSN: 0031-3998
eISSN: 1530-0447
Publisher: United States
Grant note: K23 DK110443 / NIDDK NIH HHS
Language: English
Date published: 02/2021
Academic Unit: Neurology; Psychiatry; Pediatric Psychology; Nephrology, Dialysis and Transplantation; Stead Family Department of Pediatrics; Iowa Neuroscience Institute; Radiation Oncology; Craniofacial Anomalies Research Center; Pharmacy Practice and Science
Record Identifier: 9984070627702771

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