Abstract: TH-PO1191
Association of Inflammation and Neurocognition in Pediatric Patients with CKD
Session Information
- Pediatric Nephrology: CV Health, CKD, AKI, Dialysis, Transplantation, and Health Services Research
October 22, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Pediatric Nephrology
- 1800 Pediatric Nephrology
Authors
- Carlson, Joann M., Rutgers Robert Wood Johnson Medical School Department of Pediatrics, New Brunswick, New Jersey, United States
- Matheson, Matthew, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States
- Manne, Sharon L., Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, United States
- Harshman, Lyndsay, University of Iowa Hospitals and Clinics, Iowa City, Iowa, United States
- Kogon, Amy, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
- Wong, Cynthia, Stanford University, Stanford, California, United States
- Jerry-Fluker, Judith, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States
- Johnson, Rebecca J., Children's Mercy Kansas City, Kansas City, Missouri, United States
- Jones, Erin Marie, Emory University School of Medicine, Atlanta, Georgia, United States
- Wilson, Camille, Nationwide Children's Hospital, Columbus, Ohio, United States
- Warady, Bradley A., Children's Mercy Kansas City, Kansas City, Missouri, United States
- Furth, Susan L., The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
- Hooper, Stephen R., The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
Background
Neurocognitive deficits are well documented in chronic kidney disease (CKD) and may be driven in part by systemic inflammation propagating neuroinflammation. This study examines the relationship between inflammation and neurocognition in pediatric CKD.
Methods
Participants were enrolled in the Chronic Kidney Disease in Children Study (CKiD), a multicenter, longitudinal cohort study. We examined three inflammatory markers measured in the study: CRP (measured longitudinally); IL-6 and TNF-α (measured once after study entry). Neurocognitive outcomes - assessed approximately one year after inflammatory marker measurement - included IQ (WPPSI-III/WASI-II), attention (CPT-II), executive function (D-KEFS Tower, BRIEF-2), and behavior (BASC-2 PRS). Cross-sectional associations between each inflammatory marker and neurocognitive outcomes were evaluated using separate linear regression models. Longitudinal analyses used linear mixed models on visit pairs among participants with ≥2 CRP values and concurrent neurocognitive scores, assessing the effects of both CRP level and change on IQ, D-KEFS Tower, BASC-2 BSI, and BRIEF GEC.
Results
The sample included 638 children; 61% male, median age 13 years, median duration of CKD 8 years, and median estimated GFR 49 ml/min/1.73m2 at baseline. CRP, being highly skewed, was categorized as <0.3 mg/L (32%), 0.3 to <1 mg/L (38%), 1 to <10 mg/L (24%), and ≥10mg/L (6%). IL-6 and TNF-α were normally distributed, with median [IQR] of 2.47 pg/mL [1.23, 3.97] and 4.64 pg/mL [2.99, 7.14], respectively. Cross-sectional analysis revealed no association between inflammatory markers and neurocognitive outcomes; longitudinal analysis revealed no association between level or change in CRP and neurocognitive outcomes.
Conclusion
Inflammatory markers were not associated with neurocognitive outcomes cross-sectionally or longitudinally in this sample. Interpretation is limited by single-timepoint assessment of IL-6 and TNF-α and few patients with markedly elevated CRP. Further studies with serial inflammatory biomarker measurement are needed to clarify the impact of inflammation on neurocognition in pediatric CKD.
The association between inflammatory markers and neurocognitive outcomes
Funding
- NIDDK Support