Introduction
Central nervous system studies
Neuroimaging
Electrophysiology findings
Neuropsychology findings
Author/date | Sample features | Comparison group | Findings |
---|---|---|---|
Davis et al. 1990 [28] |
n=37 | Pre-post transplant design | Mental development |
20 Dialysis at pre-transplant evaluation | Improved from pre- (mean=77.0, range 50–116) to post-transplant (mean=91.4, range 50–117) | ||
17 Conservative at pre-transplant evaluation | |||
Mean age at transplant=17.6 months | Motor development | ||
Improved from pre- (mean=68.7, range 50–86) to post-transplant (mean=85.6, range 65–109) | |||
Cognition | |||
No change from pre- (mean=92.0) to post-transplant (mean=90.4) | |||
Overall development worse with early onset of ESRD | |||
Fennell et al. 1990 [22] |
n=56 |
n=56 healthy children | Cognition |
Mean age=13.6 years | Testing at 6-month intervals | Decreased verbal ability in CKD | |
Mean age of CKD onset=6.05 years | Visual motor skills | ||
Decreased in CKD | |||
Modality: | Memory and learning | ||
Hemodialysis (7) | Decreased in CKD and loss of function over time | ||
Peritoneal dialysis (12) | Attention | ||
Kidney transplant (10) | No differences between CKD and controls | ||
Conservative (27) | |||
Lawry et al. 1994 [18] |
n=24 | Transplant compared with dialysis plus conservative | Cognition |
Modality: | IQ: no differences between dialysis plus conservative (mean=92.91, SD=16.86) vs. transplant (mean=103.00, SD=11.97) | ||
Dialysis (9) | |||
Conservative (2) | |||
Kidney transplant (13) | |||
Correlation between age at onset of illness and IQ (r=0.49) | |||
Achievement | |||
Dialysis plus conservative less than transplant in maths (P=0.020), reading (P=0.028), and written language (P=0.028) | |||
Elzouki et al. 1994 [8] | N=15 | None | Developmental screening |
Modality: | 3 of 15 with developmental delay | ||
Dialysis (6) | |||
Transplant (3) | |||
Conservative (6) | |||
Hulstijn-Dirkmaat et al. 1995 [14] |
n=31 | None | Developmental index |
Mean age=2.5 years | Testing every 6 months | Conservative (mean=90.3, SD=14.3) greater than ESRD (mean=67.6, SD=17.3) | |
Modality: | |||
Dialysis (16) | |||
Conservative (15) | Verbal, perceptual performance, and quantitative scales | ||
No change over time | |||
Mendley and Zelko 1999 [19] |
n=9 | Pre-post transplant design | Cognition (baseline only) |
Full-scale IQ mean=91.6 | |||
Mean age at pre-transplant testing=14.2 years | Verbal IQ mean=91.4 | ||
Performance IQ mean=95.1 | |||
Mean age at post-transplant testing=15.8 years | Attention | ||
Improvement in sustained attention 1-year post-transplant (P=0.039) | |||
Pre-transplant modality: | |||
Executive functioning | |||
Peritoneal dialysis (5) | Improvement in mental processing speed 1 year post transplant (P=0.008) | ||
Hemodialysis (3) | |||
Conservative (1) | |||
Mean age of onset of ESRD=11.9 years | Memory | ||
Mean duration of ESRD prior to transplant=2.5 years | Improvement in working memory 1 year post transplant (P=0.016) | ||
Warady et al. 1999 [16] |
n=28 infants | Longitudinal design | Development, general |
Modality: | 6 of 28 children below the average range at 1 year of age | ||
CAPD at ≤3 months of age | Cognition | ||
Transplant at mean age=2.1±0.8 years | Verbal IQ: 5 of 18 children below the average range at ≥4 years of age | ||
Mean age at follow-up=7.8±2.8 years (range 2.5–12.0 years) | Non-verbal IQ: 8 of 18 children below the average range at ≥4 years of age | ||
1 child within impaired range on both verbal and non-verbal IQ | |||
n=16 infants with ESRD | Longitudinal design | Development, general | |
Mean age at start of dialysis=0.38 years (range 0.02–1 year) | 2 of 8 school-aged children had general delays | ||
Duration of dialysis=17.3 months (range=1–59 months) | 2 of 8 children <5 years of age had general delays | ||
Mean age at assessment=5.84 (range 1.58–12.00 years) | Cognition | ||
IQ: 67% in average range, and 20% in low-average range (mean=86.5, range 50–102) | |||
Lower IQ scores for children with co-morbid diagnoses (mean=67.0) than for those with ESRD alone (mean=94.2) | |||
Attention | |||
7 of 14 children with hyperactivity problems | |||
Social-behavioral | |||
6 of 14 children displaying conduct problems | |||
Brouhard et al. 2000 [21] |
n=62 |
n=62 siblings | Cognition |
Mean age: 13.8±0.4 years | IQ: ESRD less than siblings | ||
Modality: 26 dialysis, 36 transplant | No difference in dialysis vs. transplant | ||
Academic achievement | |||
ESRD less than controls for all measures of spelling, reading, and mathematics | |||
No difference dialysis vs. transplant | |||
Correlation between age of diagnosis and academic achievement | |||
Correlation between parental education and academic achievement | |||
Qvist et al. 2002 [11] |
n=33 transplant recipients | None | Cognition |
Mean age at assessment=8 years (range=7–12 years) | Verbal IQ: mean=87.5 | ||
Non-verbal IQ: mean=87.5 | |||
IQ range | |||
Low: 3/33 | |||
Low-average: 14/33 | |||
Average: 14/33 | |||
Above average: 2/33 | |||
Neuropsychological battery | |||
No overall group deficits with attention, language, memory, or visuospatial abilities when compared with normative population | |||
Neuropsychological deficits | |||
Attention: 8 of 33 children | |||
Language: 2 of 33 children | |||
Memory: 6 of 33 children | |||
Visuospatial: 8 of 33 children | |||
Motor function | |||
Hemiplegia: 3 of 33 children | |||
Bilateral infarction: 1 of 33 | |||
Cerebral palsy: 1 of 33 | |||
Auditory function | |||
2 of 33 children with moderate sensorineural hearing loss |