Neurocognitive disruption in pediatric kidney transplant candidates: Medical and sociodemographic factors

Abstract

We evaluated the effects of kidney failure etiology, dialysis, and area deprivation index on the subdomains of neurocognitive functioning in pediatric kidney transplant candidates. The study included 78 pediatric kidney transplant candidates (47.4% male, 70.5% White, M.age = 11.77 years, and 51.3% patients have public insurance) who completed a pre-transplant neuropsychological evaluation between 1/1/2010 and 10/31/2022. Linear regression models were employed to complete data analyses. The mean scores of various neurocognitive functioning domains in pediatric kidney transplant candidates were significantly lower than in the general population (ps < .001). After adjusting for covariates, patients with congenital anomalies of the kidney and urinary tract (M = 87; 95% CI: 80-94) and other etiologies (M = 82; 95% CI: 76-89) had significantly lower processing speed compared to patients with nephrotic syndrome (M = 98; 95% CI: 89-107) (p = .02). Patients living in high-level deprivation neighborhoods showed significantly lower verbal skills (p = .01), working memory performance (p = .02), and full-scale IQ (p = .03) than patients living in median-level and low-level deprivation neighborhoods. Additionally, dialysis did not show significant association with neurocognitive domains ((ps ranged from .07 to .52).

Keywords: Dialysis; kidney failure; neighborhood deprivation; neurocognitive.