Risk factors for neurocognitive impairment and the relation with structural brain abnormality in children and young adults with severe chronic kidney disease

Lijdsman, Sophie; Oostrom, Kim J.; Sandwijk, Marit S van; Bouts, Antonia H.; Hoeck, Koen Van; Jong, Huib de; Oosterlaan, Jaap; Bemelman, Fréderike J.; Königs, Marsh; Groothoff, Jaap W.

doi:10.1007/s00467-022-05781-1

Cited by 8 publications

(2 citation statements)

References 45 publications

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“…Previous studies have demonstrated that DTI parameters can detect the loss of white matter structural integrity in the brain (13)(14)(15)(16). However, our study contributes by highlighting that in patients with chronic kidney disease undergoing hemodialysis, if a routine brain MRI scan is normal, then there are no significant differences in DTI parameters compared with normal.…”

Section: Significant Differences In Dti Parameters In Ckd-mhd Populationmentioning

confidence: 68%

A Cross-Sectional Study to Evaluate Diffusion Tensor Imaging Findings of the Brain in End-Stage Renal Disease (ESRD) Patients Undergoing Maintenance Hemodialysis Using Volume of Interest Method

Dighe,

Kalekar,

Kuber

et al. 2024

Nephro-Urol Mon

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Background: Cerebral small vessel disease (CSVD) is a chronic disorder affecting small vessels within the brain, increasing the risk of stroke in patients with chronic kidney disease (CKD). Diffusion tensor imaging (DTI) is a newer quantitative method for diagnosing CSVD at an early stage of pathogenesis. Objectives: This study compares various DTI parameters in multiple white matter tracts of the brain in CKD patients undergoing maintenance hemodialysis with normal controls in the Indian population using the volume of interest (VOI) method. Additionally, it correlates these DTI parameters with each other at different locations to gain insights into the pathogenesis of CSVD. Methods: After obtaining institutional ethics approval, a cross-sectional study was conducted at a tertiary care hospital over one year (June 2022 to May 2023). The study comprised seventy-five patients in the hemodialysis group and twenty-five controls. All participants underwent MRI brain examinations on a 3 Tesla MRI scanner, and the four DTI parameters - fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD), and mean diffusivity (MD) - were reviewed for nine white matter tracts to evaluate statistical differences and correlations. Results: Fractional anisotropy was significantly decreased at anterior locations – corpus callosum genu (P = 0. 357 × 10-7), right anterior corona radiata (P = 0.001), and left anterior corona radiata (P = 0.45 × 10-5). In these locations, FA negatively correlated with RD (R = -0.7904, P < 0.00001), and RD was also significantly increased. Axial diffusivity was significantly increased at posterior locations in the corpus callosum splenium (P = 0.108 × 10-5) and left posterior corona radiata (P = 0.244 × 10-5). However, none of the four DTI parameters showed significant differences between hemodialysis patients and the control group for the subset of patients with normal routine brain MRI features. The intraclass correlation coefficients (ICCs) were high for all four DTI parameters for both patients (0.78 to 0.85) and controls (0.82 to 0.89). Conclusions: This study on CKD patients undergoing maintenance hemodialysis reveals significant differences in some DTI parameters in widespread white matter tracts of the brain using the VOI method, with acceptable to excellent interobserver agreement.

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Section: Significant Differences In Dti Parameters In Ckd-mhd Populationmentioning

confidence: 68%

A Cross-Sectional Study to Evaluate Diffusion Tensor Imaging Findings of the Brain in End-Stage Renal Disease (ESRD) Patients Undergoing Maintenance Hemodialysis Using Volume of Interest Method

Dighe,

Kalekar,

Kuber

et al. 2024

Nephro-Urol Mon

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“…Slower processing speed has been associated with white matter and gray matter loss in some pediatric populations, such as preterm children [16,17]. White matter loss is also associated with chronic kidney diseases in both pediatric and adult populations [18,19]. Considering the typical onset of CAKUT during infancy, it is plausible that this condition exerts a more pronounced impact on the change of both white and gray matter compared to other etiologies of kidney failure.…”

Section: Discussionmentioning

confidence: 99%

Neurocognitive Profile in Pediatric Kidney Transplant Candidates: Effects of Medical and Sociodemographic Factors

Gu,

Anzalone,

Kane-Grade

et al. 2024

Preprint

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Background We evaluated the effects of kidney failure etiology, dialysis, and sociodemographic factors on the subdomains of intellectual functioning in pediatric kidney transplant candidates. Methods This retrospective study included 78 pediatric kidney transplant candidates who completed a Wechsler Intelligence Scale assessment during pre-transplant neuropsychological evaluation between 1/1/2010 and 10/31/2022. Linear regression models were employed to examine the effects of kidney failure etiology, dialysis status, neighborhood area deprivation, and race on subdomains of intellectual functioning. Results The mean scores of various intellectual functioning domains in pediatric kidney transplant candidates were significantly lower than in the general population (ps <0.001). After adjusting for covariates, patients with congenital anomalies of the kidney and urinary tract had significantly lower processing speed (M=85; 95% CI: 79-91) compared to patients with nephrotic syndrome (M=99; 95% CI: 90-107) and other etiologies (M=84; 95% CI: 78-90) (p=0.003). Patients living in high-level deprivation neighborhoods showed lower working memory performance (M=84, 95% CI: 77-91) than patients living in median-level (M=91, 95% CI: 87-95) and low-level (M=98, 95% CI: 92-104) neighborhood area deprivation (p=0.03). Patients from marginalized racial groups demonstrated lower verbal skills (M=80, 95% CI: 74-87) than White patients (M=92, 95% CI: 88-97) (p=0.02). Additionally, patients receiving dialysis showed higher reasoning skills (M=98, 95% CI: 90-104) than patients without dialysis (M= 90, 95% CI: 86-95) (p=0.04). Conclusions Neurocognitive development in pediatric kidney transplant candidates is associated with medical and sociodemographic factors. Strategies to monitor, treat, and accommodate neurocognitive concerns need to be considered to optimize long-term medical and social outcomes.

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Common mental health conditions and considerations in pediatric chronic kidney disease

Mai,

Dawson,

et al. 2024

Pediatr Nephrol

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Risk factors for neurocognitive impairment and the relation with structural brain abnormality in children and young adults with severe chronic kidney disease

Cited by 8 publications

References 45 publications

A Cross-Sectional Study to Evaluate Diffusion Tensor Imaging Findings of the Brain in End-Stage Renal Disease (ESRD) Patients Undergoing Maintenance Hemodialysis Using Volume of Interest Method

A Cross-Sectional Study to Evaluate Diffusion Tensor Imaging Findings of the Brain in End-Stage Renal Disease (ESRD) Patients Undergoing Maintenance Hemodialysis Using Volume of Interest Method

Neurocognitive Profile in Pediatric Kidney Transplant Candidates: Effects of Medical and Sociodemographic Factors

Common mental health conditions and considerations in pediatric chronic kidney disease

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