Neurocognitive, Social-Behavioral, and Adaptive Functioning in Preschool Children with Mild to Moderate Kidney Disease

Stephen R. Hooper, Arlene C. Gerson, J. Rebecca Johnson, Susan R. Mendley, Shlomo Shinnar, Marc B. Lande, Matthew B. Matheson, Debbie S. Gipson, Bruce Morgenstern, Bradley A. Warady, Susan L. Furth

Research output: Contribution to journalArticle

Abstract

Objective: The negative impact of end-stage kidney disease on cognitive function in children is well established, but no studies have examined the neurocognitive, social-behavioral, and adaptive behavior skills of preschool children with mild to moderate chronic kidney disease (CKD). Method: Participants included 124 preschool children with mild to moderate CKD, aged 12 to 68 months (median 5 3.7 years), and an associated mean glomerular filtration rate (GFR) of 50.0 mLmin211.73 m22. In addition to level of function and percent of participants scoring 1 SD below the test mean, regression models examined the associations between biomarkers of CKD (GFR, anemia, hypertension, seizures, and abnormal birth history), and developmental level/IQ, attention regulation, and parent ratings of executive functions, social-behavior, and adaptive behaviors. Results: Median scores for all measures were in the average range; however, 27% were deemed at risk for a developmental level/IQ <85, 20% were at-risk for attention variability, and parent ratings indicated 30% and 37% to be at risk for executive dysfunction and adaptive behavior problems, respectively. Approximately 43% were deemed at risk on 2 or more measures. None of the disease-related variables were significantly associated with these outcomes, although the presence of hypertension approached significance for attention variability (p < .09). Abnormal birth history and lower maternal education were significantly related to lower developmental level/IQ; seizures were related to lower parental ratings of executive function and adaptive behavior; and abnormal birth history was significantly related to lower ratings of adaptive behavior. When predicting risk status, the logistic regression did evidence both higher GFR and the lack of anemia to be associated with more intact developmental level/IQ. Conclusion: These findings suggest relatively intact functioning for preschool children with mild to moderate CKD, but the need for ongoing developmental surveillance in this population remains warranted, particularly for those with abnormal birth histories, seizures, and heightened disease severity.

Original languageEnglish (US)
Pages (from-to)231-238
Number of pages8
JournalJournal of Developmental and Behavioral Pediatrics
Volume37
Issue number3
DOIs
StatePublished - Jan 1 2016

Keywords

  • CKD
  • CKiD
  • adaptive behavior function in CKD
  • chronic kidney disease
  • mild to moderate CKD
  • neurobehavioral performance in early childhood CKD
  • neurocognitive function in CKD
  • preschool CKD
  • social-behavioral function in CKD

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Developmental and Educational Psychology
  • Psychiatry and Mental health

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    Hooper, S. R., Gerson, A. C., Johnson, J. R., Mendley, S. R., Shinnar, S., Lande, M. B., Matheson, M. B., Gipson, D. S., Morgenstern, B., Warady, B. A., & Furth, S. L. (2016). Neurocognitive, Social-Behavioral, and Adaptive Functioning in Preschool Children with Mild to Moderate Kidney Disease. Journal of Developmental and Behavioral Pediatrics, 37(3), 231-238. https://doi.org/10.1097/DBP.0000000000000267