TY - JOUR
T1 - Neurodevelopmental profile of infants and toddlers awaiting a kidney transplant
AU - Glad, Danielle
AU - Anzalone, Christopher
AU - Kane-Grade, Finola
AU - Gu, Lidan
AU - Evans, Michael D
AU - Kizilbash, Sarah
N1 - Publisher Copyright:
© 2024, The Author(s), under exclusive licence to International Pediatric Nephrology Association.
PY - 2024
Y1 - 2024
N2 - Background: Infants and toddlers with kidney failure are susceptible to neurodevelopmental delays due to medical comorbidities and rapid brain development in early childhood. However, research on the neuropsychological development of this patient population has been limited over the past 10 years. Methods: We performed a retrospective study to evaluate the neurodevelopmental functioning of infants/toddlers with kidney failure who completed the Bayley Scales of Infant and Toddler Development (3rd and 4th Edition) as part of a pretransplant evaluation between 2010 and 2022 (n = 23; Mage = 18 months, SD = 8.53; 16 males) using t-tests, linear model, and Pearson correlations. Results: Mean Bayley scores of participants were below normative means for cognition (M = 86.74, 95% CI = 80.53–92.94, p < 0.001), language (M = 79.20, 95% CI = 73.32–85.08, p < 0.001), and motor (M = 78.00, 95% CI = 70.15–85.85, p < 0.001) domains. After adjusting for prematurity and epilepsy, patients on dialysis had significantly lower cognitive (78.7 vs. 93.8; p = 0.001) and motor scores (67.1 vs. 85.5; p = 0.01) compared to no dialysis. Pretransplant cognitive scores were positively correlated with posttransplant Full-Scale IQ (r(8) = 0.65 p = 0.04), verbal comprehension (r(8) = 0.75 p = 0.02), and fluid reasoning (r(7) = 0.68 p = 0.045). Similarly, pretransplant language scores were positively correlated with posttransplant Full-Scale IQ (r(7) = 0.74 p = 0.03) and verbal comprehension (r(7) = 0.73 p = 0.03). Of the 16 participants who reached age > 5 years during the study period, seven were diagnosed with a neurodevelopmental disorder, including three with autism spectrum disorder. Conclusions: Infants and toddlers with kidney failure are at risk of developmental delays and later neurodevelopmental disorders. Dialysis is associated with cognitive and motor delays independent of prematurity and epilepsy. Graphical abstract: A higher resolution version of the Graphical abstract is available as Supplementary information[Figure not available: see fulltext.]
AB - Background: Infants and toddlers with kidney failure are susceptible to neurodevelopmental delays due to medical comorbidities and rapid brain development in early childhood. However, research on the neuropsychological development of this patient population has been limited over the past 10 years. Methods: We performed a retrospective study to evaluate the neurodevelopmental functioning of infants/toddlers with kidney failure who completed the Bayley Scales of Infant and Toddler Development (3rd and 4th Edition) as part of a pretransplant evaluation between 2010 and 2022 (n = 23; Mage = 18 months, SD = 8.53; 16 males) using t-tests, linear model, and Pearson correlations. Results: Mean Bayley scores of participants were below normative means for cognition (M = 86.74, 95% CI = 80.53–92.94, p < 0.001), language (M = 79.20, 95% CI = 73.32–85.08, p < 0.001), and motor (M = 78.00, 95% CI = 70.15–85.85, p < 0.001) domains. After adjusting for prematurity and epilepsy, patients on dialysis had significantly lower cognitive (78.7 vs. 93.8; p = 0.001) and motor scores (67.1 vs. 85.5; p = 0.01) compared to no dialysis. Pretransplant cognitive scores were positively correlated with posttransplant Full-Scale IQ (r(8) = 0.65 p = 0.04), verbal comprehension (r(8) = 0.75 p = 0.02), and fluid reasoning (r(7) = 0.68 p = 0.045). Similarly, pretransplant language scores were positively correlated with posttransplant Full-Scale IQ (r(7) = 0.74 p = 0.03) and verbal comprehension (r(7) = 0.73 p = 0.03). Of the 16 participants who reached age > 5 years during the study period, seven were diagnosed with a neurodevelopmental disorder, including three with autism spectrum disorder. Conclusions: Infants and toddlers with kidney failure are at risk of developmental delays and later neurodevelopmental disorders. Dialysis is associated with cognitive and motor delays independent of prematurity and epilepsy. Graphical abstract: A higher resolution version of the Graphical abstract is available as Supplementary information[Figure not available: see fulltext.]
KW - Delays
KW - Infant
KW - Kidney failure
KW - Neurocognitive
KW - Neurodevelopmental
KW - Toddler
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U2 - 10.1007/s00467-024-06282-z
DO - 10.1007/s00467-024-06282-z
M3 - Article
C2 - 38285058
AN - SCOPUS:85183404302
SN - 0931-041X
JO - Pediatric Nephrology
JF - Pediatric Nephrology
ER -