Skip to main content
Archives of Disease in Childhood logoLink to Archives of Disease in Childhood
. 2004 Jul;89(7):644–647. doi: 10.1136/adc.2003.037093

Neuropsychological functioning in end-stage renal disease

H Bawden 1, P Acott 1, J Carter 1, D Lirenman 1, G MacDonald 1, M McAllister 1, M McDonnell 1, S Shea 1, J Crocker 1
PMCID: PMC1719970  PMID: 15210497

Abstract

Aims: To compare the neuropsychological functioning and behaviour of children with non-syndromic end-stage renal disease (ESRD) and sibling controls.

Methods: The study was carried out at two tertiary care paediatric teaching hospitals, in Halifax and Vancouver, Canada. Children with ESRD were on a renal transplant waiting list and either pending dialysis or on dialysis therapy. Twenty two patient-sibling pairs were evaluated. Neuropsychological assessments consisting of measures of intelligence, academic achievement, memory, and motor abilities were carried out. Maternal ratings of behaviour and self-report rating of self-esteem were collected.

Results: The Verbal, Performance, and Full Scale IQs of patients with ESRD were significantly lower than the IQs of the sibling controls. The mean differences were 8.6, 11.7, and 10.9 points, respectively. ESRD patients also had significantly more difficulty on measures of fine motor coordination and ability to copy geometric designs than sibling controls. There were no differences between groups on measures of academic achievement, memory, behaviour, or self-esteem.

Conclusions: Although children with ESRD exhibited mild deficits on measures of intelligence and some measures of motor abilities, their neuropsychological outcome was more favourable than earlier reports indicated.

Full Text

The Full Text of this article is available as a PDF (59.4 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bock G. H., Conners C. K., Ruley J., Samango-Sprouse C. A., Conry J. A., Weiss I., Eng G., Johnson E. L., David C. T. Disturbances of brain maturation and neurodevelopment during chronic renal failure in infancy. J Pediatr. 1989 Feb;114(2):231–238. doi: 10.1016/s0022-3476(89)80788-7. [DOI] [PubMed] [Google Scholar]
  2. Brouhard B. H., Donaldson L. A., Lawry K. W., McGowan K. R., Drotar D., Davis I., Rose S., Cohn R. A., Tejani A. Cognitive functioning in children on dialysis and post-transplantation. Pediatr Transplant. 2000 Nov;4(4):261–267. doi: 10.1034/j.1399-3046.2000.00121.x. [DOI] [PubMed] [Google Scholar]
  3. Crocker John F. S., Acott Philip D., Carter James E. J., Lirenman David S., MacDonald G. Wayne, McAllister Mona, McDonnell Mary Catherine, Shea Sarah, Bawden Harry N. Neuropsychological outcome in children with acquired or congenital renal disease. Pediatr Nephrol. 2002 Sep 25;17(11):908–912. doi: 10.1007/s00467-002-0912-4. [DOI] [PubMed] [Google Scholar]
  4. Davis I. D., Chang P. N., Nevins T. E. Successful renal transplantation accelerates development in young uremic children. Pediatrics. 1990 Oct;86(4):594–600. [PubMed] [Google Scholar]
  5. Fennell R. S., 3rd, Rasbury W. C., Fennell E. B., Morris M. K. Effects of kidney transplantation on cognitive performance in a pediatric population. Pediatrics. 1984 Aug;74(2):273–278. [PubMed] [Google Scholar]
  6. Fennell R. S., Fennell E. B., Carter R. L., Mings E. L., Klausner A. B., Hurst J. R. A longitudinal study of the cognitive function of children with renal failure. Pediatr Nephrol. 1990 Jan;4(1):11–15. doi: 10.1007/BF00858429. [DOI] [PubMed] [Google Scholar]
  7. Fennell R. S., Fennell E. B., Carter R. L., Mings E. L., Klausner A. B., Hurst J. R. Association between renal function and cognition in childhood chronic renal failure. Pediatr Nephrol. 1990 Jan;4(1):16–20. doi: 10.1007/BF00858430. [DOI] [PubMed] [Google Scholar]
  8. Fletcher J. M. Memory for verbal and nonverbal stimuli in learning disability subgroups: analysis by selective reminding. J Exp Child Psychol. 1985 Oct;40(2):244–259. doi: 10.1016/0022-0965(85)90088-8. [DOI] [PubMed] [Google Scholar]
  9. Geary D. F., Haka-Ikse K. Neurodevelopmental progress of young children with chronic renal disease. Pediatrics. 1989 Jul;84(1):68–72. [PubMed] [Google Scholar]
  10. Groothoff J. W., Grootenhuis M., Dommerholt A., Gruppen M. P., Offringa M., Heymans H. S. A. Impaired cognition and schooling in adults with end stage renal disease since childhood. Arch Dis Child. 2002 Nov;87(5):380–385. doi: 10.1136/adc.87.5.380. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Lawry K. W., Brouhard B. H., Cunningham R. J. Cognitive functioning and school performance in children with renal failure. Pediatr Nephrol. 1994 Jun;8(3):326–329. doi: 10.1007/BF00866349. [DOI] [PubMed] [Google Scholar]
  12. Madden S. J., Ledermann S. E., Guerrero-Blanco M., Bruce M., Trompeter R. S. Cognitive and psychosocial outcome of infants dialysed in infancy. Child Care Health Dev. 2003 Jan;29(1):55–61. doi: 10.1046/j.1365-2214.2003.00311.x. [DOI] [PubMed] [Google Scholar]
  13. Reynolds J. M., Garralda M. E., Postlethwaite R. J., Goh D. Changes in psychosocial adjustment after renal transplantation. Arch Dis Child. 1991 Apr;66(4):508–513. doi: 10.1136/adc.66.4.508. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Rotundo A., Nevins T. E., Lipton M., Lockman L. A., Mauer S. M., Michael A. F. Progressive encephalopathy in children with chronic renal insufficiency in infancy. Kidney Int. 1982 Mar;21(3):486–491. doi: 10.1038/ki.1982.50. [DOI] [PubMed] [Google Scholar]
  15. Warady B. A., Belden B., Kohaut E. Neurodevelopmental outcome of children initiating peritoneal dialysis in early infancy. Pediatr Nephrol. 1999 Nov;13(9):759–765. doi: 10.1007/s004670050694. [DOI] [PubMed] [Google Scholar]

Articles from Archives of Disease in Childhood are provided here courtesy of BMJ Publishing Group

RESOURCES