Kidney Week

Abstract: FR-PO1181

Executive and Intellectual Functions of Young Hungarian Kidney Transplant Recipients

Session Information

• Pediatric Nephrology - I
  October 26, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Pediatric Nephrology

• 1600 Pediatric Nephrology

Authors

• Varga, Marta Molnar, Faculty of Special Education, ELTE University, Budapest, Hungary, Budapest, Hungary

Marta Molnar Varga,

• Gyori, Miklos, Faculty of Special Education, ELTE University, Budapest, Hungary, Budapest, Hungary

Miklos Gyori,

• Nagy, Anett, Faculty of Special Education, ELTE University, Budapest, Hungary, Budapest, Hungary

Anett Nagy,

• Varga, Aniko, ELTE University, Budapest, Hungary, Budapest, Hungary

Aniko Varga,

• Reusz, Gyorgy S., 1st. Department of Pediatrics, Semmelweis University, Budapest, Hungary, Budapest, Hungary

Gyorgy S. Reusz,

• Szabo, Attila J., 1st. Department of Pediatrics, Semmelweis University, Budapest, Hungary, Budapest, Hungary

Attila J. Szabo,

Background

CKD is frequently associated with impaired executive functions, intellectual problems and atypical development in children and adolescent. Results of the last decade indicate that neuropsychological outcomes with kidney transplant (Tx) recipients are more favorable than was detected in earlier reports. However, data on factors associated with neurocognitive dysfunctions in Tx recipients are limited.

Methods

We conducted a cross-sectional analysis comparing digital measuring of executive functions (using Wisconsin Card Sorting Test /WCST/, Corsi Test /Corsi/, Stroop Effect Test /STROOP/) of 26 kidney transplant recipients by matching them in pairs on gender, age, maternal education and IQ with healthy controls. Socio-demographic characteristics, laboratory data and comorbidities have been collected.

Results

The average age was 17±2 years, 73% was male, the average estimated GFR was 60±14 ml/min. Kidney transplant adolescent had a below average overall IQ (WISC-IV/WAIS-IV IQ=85±17). The first preliminary data on executive functions suggest no significant differences between the achievement of transplant and IQ matched healthy pairs in visuo-spacial short term memory (Corsi) (F=2.37, p=0.41), cognitive flexibility (WCST) (F=0.31, p=0.95) and selective attention and inhibition (STROOP) (F=2.97, p=0.32). All IQ domain of Tx recipients had significant negative correlation with transplant vintage (Full IQ scores: R=-0.52, p<0.01). The intellectual function had also inverse correlation with cumulative lifetime length of hospitalization (R=-0.47, p=0.01). Hospitalization time and maternal education had strong negative correlation (R=-0.57, p<0.01) while IQ and maternal education had no relation in our sample of Tx group (R=0.31, p=0.13). Cognitive flexibility (perseverative (R=-0.42 p=0.03) and conceptual level responses (R=-0.59 p=0.001) indicated a strong inverse correlation with lifetime cumulative dialysis vintage in Tx recipients.

Conclusion

Young kidney transplant recipients have impairments of intellectual function that are associated with transplant vintage and lifetime hospitalization. IQ matched transplant and healthy groups had no differences in executive functions. Higher dialysis vintage of Tx adolescents indicated lower cognitive flexibility.

Funding

• Government Support - Non-U.S.