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Abstract: FR-PO417

Feasibility of the NIH Toolbox Cognitive Battery for Children With Mild to Moderate CKD

Session Information

  • Pediatric Nephrology - I
    November 04, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
    Abstract Time: 10:00 AM - 12:00 PM

Category: Pediatric Nephrology

  • 1800 Pediatric Nephrology


  • Hooper, Stephen R., University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, United States
  • Johnson, Rebecca J., Children's Mercy Hospitals and Clinics, Kansas City, Missouri, United States
  • Lande, Marc, University of Rochester Medical Center, Rochester, New York, United States
  • Carlson, Joann M., Robert Wood Johnson University Hospital, New Brunswick, New Jersey, United States
  • Harshman, Lyndsay, The University of Iowa Stead Family Children's Hospital, Iowa City, Iowa, United States
  • Wilson, Camille, Nationwide Children's Hospital, Columbus, Ohio, United States
  • Dawson, Anne E., Nationwide Children's Hospital, Columbus, Ohio, United States
  • Matheson, Matthew, Johns Hopkins University Center for Teaching and Learning, Baltimore, Maryland, United States
  • Warady, Bradley A., Children's Mercy Hospitals and Clinics, Kansas City, Missouri, United States
  • Furth, Susan L., The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States

Children with CKD show cognitive difficulties in attention, working memory, and executive functions (EF). There is a need for neurocognitive surveillance in clinical research to detect these challenges, but availability of traditional neurocognitive assessments remains elusive. Computerized assessment batteries have promise to assist in this process. The NIH Toolbox Cognitive Battery (NIH-TCB) provides the opportunity to: collect assessment data in a standardized, replicable fashion; use common data elements; employ electronic scoring to reduce examiner error; and allow for increased cross-site collaborations. Its feasibility has not been tested in pediatric CKD.


The NIH-TCB has been administered over the past 3 years by trained Research Coordinators. Analyses examined level of functioning and explored the associations between cognitive outcomes, sociodemographic (age, sex, maternal education), and CKD variables (glomerular diagnosis, U25eGFR, Urine Pr/Cr, blood pressure stage).


The CKiD study is a multi-site, prospective cohort of children with eGFR 30-90ml/min/1.73m2 at entry. The sample included 110 cases, median age=16.8 yrs., 58% males, and 28% Glomerular diagnoses. Primary outcomes from the NIH-TCB included: Working Memory (active recall), Executive Functions (regulatory abilities), and Crystallized Reasoning (academic knowledge). Scores placed in the average range with mild problems present in EF. Linear regressions for EF showed better scores were associated with higher maternal education (p<.03) and less proteinuria (p<.10). For working memory, better scores were associated with less proteinuria (p<.06) and older chronological age (p<.10). For Crystallized Reasoning, better scores were associated with higher maternal education (p<.03). None of the other sociodemographic or CKD factors were associated with the cognitive outcomes.


This study is the first to utilize the NIH-TCB for children with mild to moderate CKD. Findings from NIH-TCB had good applicability in the clinical research setting to detect and describe emerging cognitive concerns. Associations between selected cognitive abilities, maternal education, and proteinuria were noted. These findings show the promise of using the NIH-TCB for clinical research in pediatric CKD.


  • NIDDK Support