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Understanding the impact of pediatric kidney transplantation on cognition: A review of the literature
Journal article   Open access   Peer reviewed

Understanding the impact of pediatric kidney transplantation on cognition: A review of the literature

Olivia Lullmann, Ellen van der Plas and Lyndsay A Harshman
Pediatric transplantation, Vol.27(8), e14597
12/2023
DOI: 10.1111/petr.14597
PMCID: PMC11034761
PMID: 37664967
url
https://doi.org/10.1111/petr.14597View
Published (Version of record) Open Access

Abstract

Background Chronic kidney disease (CKD) is a relatively rare childhood disease that is associated with a wide array of medical comorbidities. Roughly half of all pediatric patients acquire CKD due to congenital anomalies of the kidneys and urinary tract, and of those with congenital disease, 50% will progress to end-stage kidney disease (ESKD) necessitating a kidney transplantation. The medical sequelae of advanced CKD/ESKD improve dramatically following successful kidney transplantation; however, the impact of kidney transplantation on neurocognition in children is less clear. It is generally thought that cognition improves following kidney transplantation; however, our knowledge on this topic is limited by the sparsity of high-quality data in the context of the relative rarity of pediatric CKD/ESKD. Method We conducted a narrative review to gauge the scope of the literature, using the PubMed database and the following keywords: cognition, kidney, brain, pediatric, neurocognition, intelligence, executive function, transplant, immunosuppression, and neuroimaging. Results There are few published longitudinal studies, and existing work often includes wide heterogeneity in age at transplant, variable dialysis exposure/duration prior to transplant, and unaccounted cofounders which persist following transplantation, including socio-economic status. Furthermore, the impact of long-term maintenance immunosuppression on the brain and cognitive function of pediatric kidney transplant (KT) recipients remains unknown. Conclusion In this educational review, we highlight what is known on the topic of neurocognition and neuroimaging in the pediatric KT population.
Immunosuppression cognitive pediatric kidney transplant UIOWA OA Agreement

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