Abstract
Objective: To identify factors contributing to cognitive impairment in children with lupus nephritis. Study design: A cross-sectional analysis of a large multicenter national cohort of children with chronic kidney disease (CKD) using standardized measures to determine baseline neuropsychiatric function and health-related quality of life (HRQoL) in children with lupus nephritis (n = 34), and to compare baseline function with that in children with other forms of glomerular CKD (gCKD; n = 171). We used inverse probability weighting via a logistic model for propensity score analysis to achieve balance between children with lupus nephritis and those with other glomerular causes of CKD, adjusting for known confounders. We used linear regression models to compare neurocognitive outcomes between exposure groups, adjusting for current prednisone use and testing for an interaction between current prednisone use and lupus nephritis, and to test for an association between cognitive function and HRQoL. Results: Current prednisone use was independently associated with worse attention (P < .01) and better adaptive skills (P = .04), and there was a significant interaction between current prednisone use and lupus nephritis for internalizing problems, with worse parent-reported internalizing problems in children with lupus nephritis on prednisone (P = .047). Better parent-reported HRQoL was associated with better visual memory (P = .01), and better child-reported HRQoL was associated with better attention (P < .01) and inhibitory control (P < .01). Both parent and child HRQoL were associated with better measures of executive function (P = .02 and < .001, respectively). Conclusion: Children with lupus nephritis have comparable or better cognitive function than their peers with other gCKDs, which is reassuring given the multiorgan and lifelong complications associated with lupus.
| Original language | English (US) |
|---|---|
| Journal | Journal of Pediatrics |
| DOIs | |
| State | Accepted/In press - 2017 |
| Externally published | Yes |
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Keywords
- Adolescents
- Chronic kidney disease
- Glomerulonephritis
- Health-related quality of life
- Pediatric
- Psychosocial
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
Cite this
Cognitive Function in Children with Lupus Nephritis : A Cross-Sectional Comparison with Children with Other Glomerular Chronic Kidney Diseases. / Knight, Andrea; Kogon, Amy J.; Matheson, Matthew B.; Warady, Bradley A.; Furth, Susan L.; Hooper, Stephen R.
In: Journal of Pediatrics, 2017.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Cognitive Function in Children with Lupus Nephritis
T2 - A Cross-Sectional Comparison with Children with Other Glomerular Chronic Kidney Diseases
AU - Knight, Andrea
AU - Kogon, Amy J.
AU - Matheson, Matthew B.
AU - Warady, Bradley A.
AU - Furth, Susan L.
AU - Hooper, Stephen R.
PY - 2017
Y1 - 2017
N2 - Objective: To identify factors contributing to cognitive impairment in children with lupus nephritis. Study design: A cross-sectional analysis of a large multicenter national cohort of children with chronic kidney disease (CKD) using standardized measures to determine baseline neuropsychiatric function and health-related quality of life (HRQoL) in children with lupus nephritis (n = 34), and to compare baseline function with that in children with other forms of glomerular CKD (gCKD; n = 171). We used inverse probability weighting via a logistic model for propensity score analysis to achieve balance between children with lupus nephritis and those with other glomerular causes of CKD, adjusting for known confounders. We used linear regression models to compare neurocognitive outcomes between exposure groups, adjusting for current prednisone use and testing for an interaction between current prednisone use and lupus nephritis, and to test for an association between cognitive function and HRQoL. Results: Current prednisone use was independently associated with worse attention (P < .01) and better adaptive skills (P = .04), and there was a significant interaction between current prednisone use and lupus nephritis for internalizing problems, with worse parent-reported internalizing problems in children with lupus nephritis on prednisone (P = .047). Better parent-reported HRQoL was associated with better visual memory (P = .01), and better child-reported HRQoL was associated with better attention (P < .01) and inhibitory control (P < .01). Both parent and child HRQoL were associated with better measures of executive function (P = .02 and < .001, respectively). Conclusion: Children with lupus nephritis have comparable or better cognitive function than their peers with other gCKDs, which is reassuring given the multiorgan and lifelong complications associated with lupus.
AB - Objective: To identify factors contributing to cognitive impairment in children with lupus nephritis. Study design: A cross-sectional analysis of a large multicenter national cohort of children with chronic kidney disease (CKD) using standardized measures to determine baseline neuropsychiatric function and health-related quality of life (HRQoL) in children with lupus nephritis (n = 34), and to compare baseline function with that in children with other forms of glomerular CKD (gCKD; n = 171). We used inverse probability weighting via a logistic model for propensity score analysis to achieve balance between children with lupus nephritis and those with other glomerular causes of CKD, adjusting for known confounders. We used linear regression models to compare neurocognitive outcomes between exposure groups, adjusting for current prednisone use and testing for an interaction between current prednisone use and lupus nephritis, and to test for an association between cognitive function and HRQoL. Results: Current prednisone use was independently associated with worse attention (P < .01) and better adaptive skills (P = .04), and there was a significant interaction between current prednisone use and lupus nephritis for internalizing problems, with worse parent-reported internalizing problems in children with lupus nephritis on prednisone (P = .047). Better parent-reported HRQoL was associated with better visual memory (P = .01), and better child-reported HRQoL was associated with better attention (P < .01) and inhibitory control (P < .01). Both parent and child HRQoL were associated with better measures of executive function (P = .02 and < .001, respectively). Conclusion: Children with lupus nephritis have comparable or better cognitive function than their peers with other gCKDs, which is reassuring given the multiorgan and lifelong complications associated with lupus.
KW - Adolescents
KW - Chronic kidney disease
KW - Glomerulonephritis
KW - Health-related quality of life
KW - Pediatric
KW - Psychosocial
UR - http://www.scopus.com/inward/record.url?scp=85024490384&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85024490384&partnerID=8YFLogxK
U2 - 10.1016/j.jpeds.2017.06.044
DO - 10.1016/j.jpeds.2017.06.044
M3 - Article
C2 - 28734655
AN - SCOPUS:85024490384
JO - Journal of Pediatrics
JF - Journal of Pediatrics
SN - 0022-3476
ER -