PDF(Pubmed)
Abstract：
UNASSIGNED: We evaluated the effects of kidney failure etiology, dialysis, and sociodemographic factors on the subdomains of intellectual functioning in pediatric kidney transplant candidates.
UNASSIGNED: This retrospective study included 78 pediatric kidney transplant candidates who completed a Wechsler Intelligence Scale assessment during pre-transplant neuropsychological evaluation between 1/1/2010 and 10/31/2022. Linear regression models were employed to examine the effects of kidney failure etiology, dialysis status, neighborhood area deprivation, and race on subdomains of intellectual functioning.
UNASSIGNED: The mean scores of various intellectual functioning domains in pediatric kidney transplant candidates were significantly lower than in the general population (ps <0.001). After adjusting for covariates, patients with congenital anomalies of the kidney and urinary tract had significantly lower processing speed (M=85; 95% CI: 79-91) compared to patients with nephrotic syndrome (M=99; 95% CI: 90-107) and other etiologies (M=84; 95% CI: 78-90) (p=0.003). Patients living in high-level deprivation neighborhoods showed lower working memory performance (M=84, 95% CI: 77-91) than patients living in median-level (M=91, 95% CI: 87-95) and low-level (M=98, 95% CI: 92-104) neighborhood area deprivation (p=0.03). Patients from marginalized racial groups demonstrated lower verbal skills (M=80, 95% CI: 74-87) than White patients (M=92, 95% CI: 88-97) (p=0.02). Additionally, patients receiving dialysis showed higher reasoning skills (M=98, 95% CI: 90-104) than patients without dialysis (M= 90, 95% CI: 86-95) (p=0.04).
UNASSIGNED: Neurocognitive development in pediatric kidney transplant candidates is associated with medical and sociodemographic factors. Strategies to monitor, treat, and accommodate neurocognitive concerns need to be considered to optimize long-term medical and social outcomes.
UNASSIGNED: This retrospective study included 78 pediatric kidney transplant candidates who completed a Wechsler Intelligence Scale assessment during pre-transplant neuropsychological evaluation between 1/1/2010 and 10/31/2022. Linear regression models were employed to examine the effects of kidney failure etiology, dialysis status, neighborhood area deprivation, and race on subdomains of intellectual functioning.
UNASSIGNED: The mean scores of various intellectual functioning domains in pediatric kidney transplant candidates were significantly lower than in the general population (ps <0.001). After adjusting for covariates, patients with congenital anomalies of the kidney and urinary tract had significantly lower processing speed (M=85; 95% CI: 79-91) compared to patients with nephrotic syndrome (M=99; 95% CI: 90-107) and other etiologies (M=84; 95% CI: 78-90) (p=0.003). Patients living in high-level deprivation neighborhoods showed lower working memory performance (M=84, 95% CI: 77-91) than patients living in median-level (M=91, 95% CI: 87-95) and low-level (M=98, 95% CI: 92-104) neighborhood area deprivation (p=0.03). Patients from marginalized racial groups demonstrated lower verbal skills (M=80, 95% CI: 74-87) than White patients (M=92, 95% CI: 88-97) (p=0.02). Additionally, patients receiving dialysis showed higher reasoning skills (M=98, 95% CI: 90-104) than patients without dialysis (M= 90, 95% CI: 86-95) (p=0.04).
UNASSIGNED: Neurocognitive development in pediatric kidney transplant candidates is associated with medical and sociodemographic factors. Strategies to monitor, treat, and accommodate neurocognitive concerns need to be considered to optimize long-term medical and social outcomes.
摘要：
背景我们评估了肾衰竭病因的影响，透析,和社会人口统计学因素对小儿肾移植候选人智力功能亚域的影响。方法这项回顾性研究包括78名儿童肾移植候选人，他们在2010年1月1日至2022年10月31日之间的移植前神经心理学评估期间完成了韦氏智力量表评估。线性回归模型用于检查肾衰竭病因的影响，透析状态,邻里面积剥夺，和智力功能子领域的种族。结果小儿肾移植患者的各种智力功能领域的平均得分显着低于普通人群（ps<0.001）。在调整协变量后，与肾病综合征患者(M=99;95%CI:90-107)和其他病因患者(M=84;95%CI:78-90)相比,先天性肾脏和泌尿道异常患者的处理速度(M=85;95%CI:79-91)明显更低(P=0.003).生活在高水平剥夺社区的患者的工作记忆表现（M=84，95％CI：77-91）低于生活在中位数水平（M=91，95％CI：87-95）和低水平（M=98，95％CI：92-104）的患者。与白人患者（M=92，95％CI：88-97）相比，边缘化种族群体的患者表现出更低的言语技能（M=80，95％CI：74-87）（p=0.02）。此外,接受透析的患者(M=98,95%CI:90-104)比未接受透析的患者(M=90,95%CI:86-95)表现出更高的推理能力(p=0.04).结论儿童肾移植候选人的神经认知发育与医学和社会人口统计学因素有关。监测的策略，请客,和适应神经认知问题需要考虑，以优化长期的医疗和社会结果。
