Neurocognitive functioning of children and adolescents with mild-to-moderate chronic kidney disease

Stephen R. Hooper, Arlene C. Gerson, Robert W. Butler, Debbie S. Gipson, Susan R. Mendley, Marc B. Lande, Shlomo Shinnar, Alicia Wentz, Matthew Matheson, Christopher Cox, Susan L. Furth, Bradley A. Warady

Research output: Contribution to journalArticle

74 Citations (Scopus)

Abstract

Background and objectives Few data exist on the neurocognitive functioning of children with mild-to-moderate chronic kidney disease (CKD). The primary objectives of this paper are (1) to determine the neurocognitive status in this population and (2) to identify sociodemographic and health-status variables associated with neurocognitive functioning. Design, setting, participants, & measurements This was a cross-sectional study of 368 children, aged 6 to 16 years, from the Chronic Kidney Disease in Children (CKiD) cohort. Median iGFR was 43 ml/min per 1.73 m 2, and the median duration of CKD was 8.0 years. Approximately 26% had underlying glomerular disease. Measures of intelligence, academic achievement, attention regulation, and executive functioning were obtained at study entry. The prevalence of neurocognitive deficits was determined by comparing participant scores on each measure of neurocognitive functioning with normative data. The association between hypothesized predictors of neurocognitive dysfunction was evaluated using multivariate regression analyses. Results Neurocognitive functioning was within the average range for the entire group; however, 21% to 40% of participants scored at least one SD below the mean on measures of intelligence quotient (IQ), academic achievement, attention regulation, or executive functioning. Higher iohexol-based GFR (iGFR) predicted a lesser risk for poor performance on measures of executive function. Participants having elevated proteinuria (i.e., urine protein/creatinine >2) scored lower on verbal IQ, full-scale IQ, and attention variability than those without elevated proteinuria. Conclusions Whereas most children with mild-to-moderate CKD have no major neurocognitive deficits, a substantial percentage did show neurocognitive dysfunction that places them at risk for poor long-term educational and occupational outcomes.

Original languageEnglish (US)
Pages (from-to)1824-1830
Number of pages7
JournalClinical Journal of the American Society of Nephrology
Volume6
Issue number8
DOIs
StatePublished - Aug 1 2011

Fingerprint

Intelligence
Chronic Renal Insufficiency
Iohexol
Proteinuria
Executive Function
Health Status
Creatinine
Multivariate Analysis
Cross-Sectional Studies
Regression Analysis
Urine
Population
Proteins

ASJC Scopus subject areas

  • Nephrology
  • Transplantation
  • Epidemiology
  • Critical Care and Intensive Care Medicine

Cite this

Hooper, S. R., Gerson, A. C., Butler, R. W., Gipson, D. S., Mendley, S. R., Lande, M. B., ... Warady, B. A. (2011). Neurocognitive functioning of children and adolescents with mild-to-moderate chronic kidney disease. Clinical Journal of the American Society of Nephrology, 6(8), 1824-1830. https://doi.org/10.2215/CJN.09751110

Neurocognitive functioning of children and adolescents with mild-to-moderate chronic kidney disease. / Hooper, Stephen R.; Gerson, Arlene C.; Butler, Robert W.; Gipson, Debbie S.; Mendley, Susan R.; Lande, Marc B.; Shinnar, Shlomo; Wentz, Alicia; Matheson, Matthew; Cox, Christopher; Furth, Susan L.; Warady, Bradley A.

In: Clinical Journal of the American Society of Nephrology, Vol. 6, No. 8, 01.08.2011, p. 1824-1830.

Research output: Contribution to journalArticle

Hooper, SR, Gerson, AC, Butler, RW, Gipson, DS, Mendley, SR, Lande, MB, Shinnar, S, Wentz, A, Matheson, M, Cox, C, Furth, SL & Warady, BA 2011, 'Neurocognitive functioning of children and adolescents with mild-to-moderate chronic kidney disease', Clinical Journal of the American Society of Nephrology, vol. 6, no. 8, pp. 1824-1830. https://doi.org/10.2215/CJN.09751110
Hooper, Stephen R. ; Gerson, Arlene C. ; Butler, Robert W. ; Gipson, Debbie S. ; Mendley, Susan R. ; Lande, Marc B. ; Shinnar, Shlomo ; Wentz, Alicia ; Matheson, Matthew ; Cox, Christopher ; Furth, Susan L. ; Warady, Bradley A. / Neurocognitive functioning of children and adolescents with mild-to-moderate chronic kidney disease. In: Clinical Journal of the American Society of Nephrology. 2011 ; Vol. 6, No. 8. pp. 1824-1830.
@article{dd8f4dbc2f03470fb51b81f2ef6b924d,
title = "Neurocognitive functioning of children and adolescents with mild-to-moderate chronic kidney disease",
abstract = "Background and objectives Few data exist on the neurocognitive functioning of children with mild-to-moderate chronic kidney disease (CKD). The primary objectives of this paper are (1) to determine the neurocognitive status in this population and (2) to identify sociodemographic and health-status variables associated with neurocognitive functioning. Design, setting, participants, & measurements This was a cross-sectional study of 368 children, aged 6 to 16 years, from the Chronic Kidney Disease in Children (CKiD) cohort. Median iGFR was 43 ml/min per 1.73 m 2, and the median duration of CKD was 8.0 years. Approximately 26{\%} had underlying glomerular disease. Measures of intelligence, academic achievement, attention regulation, and executive functioning were obtained at study entry. The prevalence of neurocognitive deficits was determined by comparing participant scores on each measure of neurocognitive functioning with normative data. The association between hypothesized predictors of neurocognitive dysfunction was evaluated using multivariate regression analyses. Results Neurocognitive functioning was within the average range for the entire group; however, 21{\%} to 40{\%} of participants scored at least one SD below the mean on measures of intelligence quotient (IQ), academic achievement, attention regulation, or executive functioning. Higher iohexol-based GFR (iGFR) predicted a lesser risk for poor performance on measures of executive function. Participants having elevated proteinuria (i.e., urine protein/creatinine >2) scored lower on verbal IQ, full-scale IQ, and attention variability than those without elevated proteinuria. Conclusions Whereas most children with mild-to-moderate CKD have no major neurocognitive deficits, a substantial percentage did show neurocognitive dysfunction that places them at risk for poor long-term educational and occupational outcomes.",
author = "Hooper, {Stephen R.} and Gerson, {Arlene C.} and Butler, {Robert W.} and Gipson, {Debbie S.} and Mendley, {Susan R.} and Lande, {Marc B.} and Shlomo Shinnar and Alicia Wentz and Matthew Matheson and Christopher Cox and Furth, {Susan L.} and Warady, {Bradley A.}",
year = "2011",
month = "8",
day = "1",
doi = "10.2215/CJN.09751110",
language = "English (US)",
volume = "6",
pages = "1824--1830",
journal = "Clinical Journal of the American Society of Nephrology",
issn = "1555-9041",
publisher = "American Society of Nephrology",
number = "8",

}

TY - JOUR

T1 - Neurocognitive functioning of children and adolescents with mild-to-moderate chronic kidney disease

AU - Hooper, Stephen R.

AU - Gerson, Arlene C.

AU - Butler, Robert W.

AU - Gipson, Debbie S.

AU - Mendley, Susan R.

AU - Lande, Marc B.

AU - Shinnar, Shlomo

AU - Wentz, Alicia

AU - Matheson, Matthew

AU - Cox, Christopher

AU - Furth, Susan L.

AU - Warady, Bradley A.

PY - 2011/8/1

Y1 - 2011/8/1

N2 - Background and objectives Few data exist on the neurocognitive functioning of children with mild-to-moderate chronic kidney disease (CKD). The primary objectives of this paper are (1) to determine the neurocognitive status in this population and (2) to identify sociodemographic and health-status variables associated with neurocognitive functioning. Design, setting, participants, & measurements This was a cross-sectional study of 368 children, aged 6 to 16 years, from the Chronic Kidney Disease in Children (CKiD) cohort. Median iGFR was 43 ml/min per 1.73 m 2, and the median duration of CKD was 8.0 years. Approximately 26% had underlying glomerular disease. Measures of intelligence, academic achievement, attention regulation, and executive functioning were obtained at study entry. The prevalence of neurocognitive deficits was determined by comparing participant scores on each measure of neurocognitive functioning with normative data. The association between hypothesized predictors of neurocognitive dysfunction was evaluated using multivariate regression analyses. Results Neurocognitive functioning was within the average range for the entire group; however, 21% to 40% of participants scored at least one SD below the mean on measures of intelligence quotient (IQ), academic achievement, attention regulation, or executive functioning. Higher iohexol-based GFR (iGFR) predicted a lesser risk for poor performance on measures of executive function. Participants having elevated proteinuria (i.e., urine protein/creatinine >2) scored lower on verbal IQ, full-scale IQ, and attention variability than those without elevated proteinuria. Conclusions Whereas most children with mild-to-moderate CKD have no major neurocognitive deficits, a substantial percentage did show neurocognitive dysfunction that places them at risk for poor long-term educational and occupational outcomes.

AB - Background and objectives Few data exist on the neurocognitive functioning of children with mild-to-moderate chronic kidney disease (CKD). The primary objectives of this paper are (1) to determine the neurocognitive status in this population and (2) to identify sociodemographic and health-status variables associated with neurocognitive functioning. Design, setting, participants, & measurements This was a cross-sectional study of 368 children, aged 6 to 16 years, from the Chronic Kidney Disease in Children (CKiD) cohort. Median iGFR was 43 ml/min per 1.73 m 2, and the median duration of CKD was 8.0 years. Approximately 26% had underlying glomerular disease. Measures of intelligence, academic achievement, attention regulation, and executive functioning were obtained at study entry. The prevalence of neurocognitive deficits was determined by comparing participant scores on each measure of neurocognitive functioning with normative data. The association between hypothesized predictors of neurocognitive dysfunction was evaluated using multivariate regression analyses. Results Neurocognitive functioning was within the average range for the entire group; however, 21% to 40% of participants scored at least one SD below the mean on measures of intelligence quotient (IQ), academic achievement, attention regulation, or executive functioning. Higher iohexol-based GFR (iGFR) predicted a lesser risk for poor performance on measures of executive function. Participants having elevated proteinuria (i.e., urine protein/creatinine >2) scored lower on verbal IQ, full-scale IQ, and attention variability than those without elevated proteinuria. Conclusions Whereas most children with mild-to-moderate CKD have no major neurocognitive deficits, a substantial percentage did show neurocognitive dysfunction that places them at risk for poor long-term educational and occupational outcomes.

UR - http://www.scopus.com/inward/record.url?scp=80051556387&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80051556387&partnerID=8YFLogxK

U2 - 10.2215/CJN.09751110

DO - 10.2215/CJN.09751110

M3 - Article

C2 - 21737850

AN - SCOPUS:80051556387

VL - 6

SP - 1824

EP - 1830

JO - Clinical Journal of the American Society of Nephrology

JF - Clinical Journal of the American Society of Nephrology

SN - 1555-9041

IS - 8

ER -