Psychiatry Research EG

Background Studying the impact of chronic kidney disease on neurocognitive functions is a critical element for providing optimal care to these children who might suffer from its detrimental consequence on their psychosocial life. Aim The aim of the study was to assess the cognitive functions in adolescents with endstage renal disease (ESRD) under regular hemodialysis compared with healthy controls. Patients and methods We studied 40 adolescents – 20 patients with ESRD on regular dialysis and 20 controls closely matched with the patient in terms of their age, sex, and educational level. Patients were recruited from the pediatric dialysis unit, Menoufia University hospitals, with dialysis durations ranging from 0.5 to 8.5 years with mean 3.25± 2.28 years. They were assessed using Raven’s Progressive Matrices tests (for fluid intelligence), and a computerized battery composed of Spatial Span (visual–spatial working memory task), Tower of London task (measuring planning and problem-solving ability), and the Go/No Go task (a task assessing response inhibition, set shifting, and attention). We, furthermore, assessed disease-related variables impacting the cognitive functions of the patients. Results The average age of the patients was 14.4± 3.315 years, and that of the controls was 13.7± 1.46 years. The fluid IQ for the patients was significantly lower than the controls (Po0.0001): only nine patients were above average level of intelligence (Z75%). Patients tended to score lower on Spatial Span test compared with the controls (correct trials: 5.4 ±1.81 vs. 7.55 ± 1.23; memory span: 3.6 ± 0.82 vs. 4.65 ±0.81, respectively). In the Tower of London test, the patients’ total number of correct trials was less than that of controls (5.78± 2.65 vs. 7.3 ± 1.75). Patients showed more Go errors than did controls (Po0.0001) on the Go/No Go task. Patients’ scores on Spatial Span test were influenced by lower hemoglobin concentration. In addition, hypertensive patients showed shorter start time in the Tower of London test and more P-No/Go error on the Go/No Go task. Neither duration of dialysis nor the urea reduction ratio significantly affected cognitive test. Conclusion Our findings provide evidence that the fluid intelligence and cognitive function of adolescents with ESRD on dialysis fall within the low average on most tasks. Furthermore, hypertension and anemia potentially place children with ESRD at an increased risk for neurocognitive deficits, which consequently places them at risk for poor long-term educational and occupational outcomes. Keywords: adolescents, assessment, cognitive, hemodialysis