Journal article
Neurocognitive deficits may not resolve following pediatric kidney transplantation
Pediatric transplantation, Vol.27(4), e14505
06/2023
DOI: 10.1111/petr.14505
PMCID: PMC11001201
PMID: 36932049
Appears in UI Libraries Support Open Access
Abstract
Pediatric chronic kidney disease (CKD) patients are at risk for cognitive deficits with worsening disease progression. Limited, existing cross-sectional studies suggest that cognitive deficits may improve following kidney transplantation. We sought to assess cognitive performance in relationship to kidney transplantation and kidney-specific medical variables in a sample of pediatric kidney transplant patients who provided cross-sectional and longitudinal observations.
A retrospective chart review was conducted in patients who completed pre- and/or post-transplant neurocognitive testing at the University of Iowa from 2015-2021. Cognitive outcomes were investigated with developmentally appropriate, standardized measures. Mixed linear models estimated the impact of transplant status on cognitive function (z-scores). Subsequent post-hoc t-tests on change scores were limited to patients who had provided pre- and post-transplant assessments.
Thirty eight patients underwent cognitive assessments: 10 had both pre- and post-transplant cognitive assessments, 11 had pre-transplant assessments only, and 17 had post-transplant data only. Post-transplant status was associated with significantly lower full-scale IQ and slower processing speed compared to pre-transplant status (estimate = -0.32, 95% confidence interval [CI] = -0.52: -0.12; estimate = -0.86, CI = -1.17: -0.55, respectively). Post-hoc analyses confirmed results from the mixed models (FSIQ change score = -0.34, 95% CI = -0.56: -0.12; processing speed change score = -0.98, CI = -1.28: -0.68). Finally, being ≥80 months old at transplant was associated with substantially lower FSIQ compared to being <80 months (estimate = -1.25, 95% CI = -1.94: -0.56).
Our results highlight the importance of monitoring cognitive function following pediatric kidney transplant and identify older transplant age as a risk factor for cognitive deficits.
Details
- Title: Subtitle
- Neurocognitive deficits may not resolve following pediatric kidney transplantation
- Creators
- Olivia Lullmann - Stead Family Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, Iowa, USAAmy L Conrad - University of IowaEmily J Steinbach - Stead Family Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, Iowa, USATammy Wilgenbusch - Stead Family Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, Iowa, USALyndsay A Harshman - Stead Family Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, Iowa, USAEllen van der Plas - University of Arkansas for Medical Sciences
- Resource Type
- Journal article
- Publication Details
- Pediatric transplantation, Vol.27(4), e14505
- DOI
- 10.1111/petr.14505
- PMID
- 36932049
- PMCID
- PMC11001201
- NLM abbreviation
- Pediatr Transplant
- ISSN
- 1397-3142
- eISSN
- 1399-3046
- Publisher
- Wiley
- Grant note
- R01DK128835 / NIDDK NIH HHS
- Language
- English
- Electronic publication date
- 03/17/2023
- Date published
- 06/2023
- Academic Unit
- Psychiatry; Pediatric Psychology; Nephrology, Dialysis and Transplantation; Stead Family Department of Pediatrics; Iowa Neuroscience Institute; Biology; Radiation Oncology; Craniofacial Anomalies Research Center
- Record Identifier
- 9984380369602771
Metrics
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