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Kidney Week

Abstract: SA-PO387

Neurocognitive Profile of Pediatric Kidney Transplant Candidates Aged 3 to 17 Years

Session Information

  • Pediatric Nephrology - III
    November 04, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Pediatric Nephrology

  • 1900 Pediatric Nephrology

Authors

  • Gu, Lidan, University of Minnesota Twin Cities, Minneapolis, Minnesota, United States
  • Kane-Grade, Finola E., University of Minnesota Twin Cities, Minneapolis, Minnesota, United States
  • Anzalone, Christopher J., University of Minnesota Twin Cities, Minneapolis, Minnesota, United States
  • Glad, Danielle, University of Minnesota Twin Cities, Minneapolis, Minnesota, United States
  • Evans, Michael David, University of Minnesota Twin Cities, Minneapolis, Minnesota, United States
  • Kizilbash, Sarah J., University of Minnesota Twin Cities, Minneapolis, Minnesota, United States
Background

Pediatric kidney transplant candidates frequently undergo pre-transplant neuropsychological evaluation. However, little is known about the neuropsychological profile of children awaiting a kidney transplant.

Methods

One hundred and one patients aged 3 to 17 years completed pretransplant neuropsychological evaluations at our center. Standardized tests were administered. Correlations between these test scores and age as well as dialysis duration were examined using Pearson Correlations. The effects of the cause of ESKD and race on test performances were evaluated using multivariate analysis of variance (MANOVA), adjusting for dialysis duration and age at testing.

Results

The mean age of our study cohort was 11.1 years (SD=4.2). The mean Full-Scale IQ of our cohort was significantly lower than general population at 87.3 (SD=16.8) (t= -6.64, p<.001). Age was significantly correlated with reasoning scores (r=.36, p=.003). Dialysis duration was negatively correlated with memory scores as measured by CVLT-C (r=-.323, p=.02) and visual organization scores as measured by the Rey-Osterrieth copy test (r=-.58, p=.003). After adjusting for age at testing and dialysis duration, the cause of ESKD was significantly associated with overall IQ (F(2)=3.3, p=.04) and verbal comprehension (F(2)=3.3, p=.05) performance (see figure). Race (F(1)=7.3, p=.009) and insurance type (F(1)=3.9, p=.05) were also significantly associated with verbal comprehension.

Conclusion

Pediatric kidney transplant candidates are at high risk for developing neurocognitive deficits, including lower overall IQ. Younger patients are at higher risk for abstract reasoning deficits, and patients with long dialysis duration are at higher risk for developing memory and visual organization difficulties. In addition, our results suggest that patients with CAKUT tend to have lower IQ scores versus patients with nephrotic syndrome, and white patients tend to perform better than patients of color on verbal abilities.

FSIQ