Neurocognitive functions and educational outcomes in children with chronic renal disease.

Abstract

Introduction: Chronic kidney disease (CKD) in children is a major global health problem. They are at risk for developing cognitive functions impairment more than adults due to the development of CKD during crucial stages of brain development. Aim of the study: To assess the neurocognitive status and educational outcomes in children with CKD stages 2-5. Methods: A cross sectional study was conducted on 75 patients with CKD, & 25 controls. Neurocognitive status was assessed using WIQ (Wechsler Intelligent Quotient), Benton Visual Retention Test (BVRT), computerized Wisconsin Card Sorting Test (WCST) and structural MRI Brain. Results: Children with CKD had significantly lower total, verbal, performance IQ and a disability at visual memory and attention denoted by worse performance at BVRT compared to the healthy controls. Scores of CKD patients at WCST were worse than the control, thus denoting a disability at brain executive functions. For MRI, white matter lesions were reported in 2 patients on regular hemodialysis. Conclusions: Children with CKD may have average to low-average cognition compared with the general population, with significant deficits at educational outcomes, visual memory, attention, & executive function. Limitations: We could not assess the longitudinal change in cognitive functions with advancing CKD, as the study was a cross sectional one with relatively small sample size. Implication of Practice: This study highlighted the importance of implementing changes in the routine care of children with CKD encouraging better nutrition and educational programs.

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