Kerry Chen|Madeleine Didsbury|Anita van Zwieten|Martin Howell|Siah Kim|Allison Tong|Kirsten Howard|Natasha Nassar|Belinda Barton|Sun?ica Lah|Jennifer Lorenzo|Giovanni Strippoli|Suetonia C. Palmer|Armando Teixeira?Pinto|Fiona Mackie|Steven McTaggart|Amanda Walker|Tonya Kara|Jonathan C. Craig|Germaine Wong
Neurocognitive and Educational Outcomes in Children and Adolescents with CKD
Children's Hospital at Westmead|University of Sydney
background objectives poor cognition affect educational attainment extent neurocognitive impairment children ckd well understood systematic review assessed global domainspecific cognition academic skills children ckd whether outcomes varied ckd stage design setting participants amp measurements electronic databases searched observational studies children ckd ages 21 years old younger assessed neurocognitive educational outcomes risk bias assessed using modified newcastleottawa scale used random effects models expressed estimates mean differences 95 confidence intervals stratified ckd stage results thirtyfour studies 25 crosssectional n 2095 nine cohort n 991 included overall risk bias high selection measurement biases global cognition fullscale intelligence quotient children ckd classified low average compared general population mean differences 95 confidence intervals fullscale intelligence quotient 105 95 confidence interval 132 772 ckd stages n 758 939 95 confidence interval 126 618 mild moderate stage ckd n 582 162 95 confidence interval 332 086 dialysis n 23 112 95 confidence interval 178 450 transplant n 153 direct comparisons showed children mild moderate stage ckd kidney transplants scored 112 95 confidence interval 298 194 101 95 confidence interval 181 220 fullscale intelligence quotient points higher children dialysis children ckd also lower scores general population executive function memory verbal visual domains compared children without ckd mean differences academic skills n 518 ranged 157 122 mathematics 904 017 reading 142 253 spelling conclusions children ckd may lowaverage cognition compared general population mild deficits observed across academic skills executive function visual verbal memory limited evidence suggests children dialysis may greatest risk compared children mild moderate stage ckd transplant recipients