Summary: Pediatric chronic kidney disease (CKD) is associated with deficits in neurocognitive
functioning, ranging from mild to severe, and correlated with the severity of kidney
disease. Clinical variables that are associated with neurocognitive deficits include
lower kidney function, hypertension, proteinuria, and metabolic acidosis. Commonly
reported neurocognitive difficulties include academic underachievement and deficits
in attention regulation and executive function as well as somewhat lower intellectual
abilities compared with peer and normative data. Although often mild, these neurocognitive
deficits may have broad implications for quality of life and likely contribute to
both poorer high school graduation rates and long-term underemployment in the adult
CKD population. The presence of neurocognitive deficits in predialytic CKD has been
well characterized, but further longitudinal research is warranted to describe cognitive
changes as children progress from early stage CKD to kidney replacement therapy. Such
studies should include both cognitive and neuroimaging evaluations to better inform
the impact of CKD progression on neurocognitive outcomes.
Keywords
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