Department of Psychiatry, College of Medicine, Jeju National University, Jeju, Korea.
Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea.
J Korean Med Sci. 2021 May 24;36(20):e138. doi: 10.3346/jkms.2021.36.e138.
Chronic kidney disease (CKD) has a negative impact on growth and development in children and is a risk factor for neurocognitive impairment; however, there is limited research on the cognitive function of children and adolescents with CKD. This study therefore aimed to investigate the mean intelligence and risk factors for low intelligence in children and adolescents with CKD.
Eighty-one patients with CKD under 18 years old were included in the KoreaN cohort study for Outcomes in patients With Pediatric Chronic Kidney Disease (KNOW-Ped CKD). Participants completed either the Wechsler Intelligence Scale for Children (6-16 years), or Wechsler Adult Intelligence Scale (> 16 years).
The mean full-scale intelligence quotient (IQ) was 91 ± 19; 24.7% of participants scored a full-scale IQ below 80. Participants with a short stature (height Z scores < -1.88), failure to thrive (weight Z scores < -1.65), more severe CKD stage (≥ IIIb), longer duration of CKD (≥ 5 years), and those who were Medicare or Medicaid beneficiaries, had significantly lower mean full-scale IQs.
On linear regression analysis, the association between the full-scale IQ, and longer duration of CKD and growth failure, remained significant after controlling for demographic and clinical variables. It is therefore necessary to investigate cognitive impairment in pediatric patients with CKD who exhibit growth failure or for a longer postmorbid period. It is believed that early interventions, such as kidney transplantation, will have a positive effect on IQ in children with CKD, as the disease negatively affects IQ due to poor glomerular filtration rate over time.
ClinicalTrials.gov Identifier: NCT02165878.
慢性肾脏病（CKD）对儿童的生长发育有负面影响，是神经认知障碍的一个危险因素；然而，对于 CKD 患儿的认知功能，研究有限。因此，本研究旨在探讨 CKD 患儿的平均智力和智力低下的危险因素。
将 81 名年龄在 18 岁以下的 CKD 患者纳入韩国儿科慢性肾脏病患者结局研究（KNOW-Ped CKD）的队列研究。参与者完成了韦氏儿童智力量表（6-16 岁）或韦氏成人智力量表（＞16 岁）。
平均总智商（IQ）为 91±19；24.7%的参与者总智商得分低于 80。身高 Z 分数＜-1.88、生长迟缓（体重 Z 分数＜-1.65）、更严重的 CKD 分期（≥IIIb）、CKD 持续时间较长（≥5 年）以及医疗保险或医疗补助受益人的参与者，其平均总智商明显较低。
在线性回归分析中，在校正人口统计学和临床变量后，总智商与 CKD 持续时间较长和生长失败之间的关联仍然显著。因此，有必要调查表现出生长失败或更长发病期的 CKD 儿科患者的认知障碍。人们认为，早期干预，如肾移植，将对 CKD 儿童的智商产生积极影响，因为随着时间的推移，疾病会因肾小球滤过率差而对智商产生负面影响。
ClinicalTrials.gov 标识符：NCT02165878。
