Department of Pediatric Nephrology, Gazi University, Beşevler, Ankara, Turkey.
Department of Pediatrics, Gazi University, Ankara, Turkey.
J Nephrol. 2022 Sep;35(7):1873-1883. doi: 10.1007/s40620-022-01382-1. Epub 2022 Jul 23.
Children with chronic kidney disease and on kidney replacement therapy may have neurocognitive and psychosocial disorders. Although kidney transplantation improves quality of life, psychological problems may exist in children who undergo kidney transplantation. Herein, we aimed to investigate attention-deficit hyperactivity disorder-like symptoms with MOXO-continuous performance test in children with pre-dialysis chronic kidney disease, dialysis and kidney transplantation.
The MOXO-continuous performance test measures four domains of attention-deficit hyperactivity disorder-like symptoms, including attention, timeliness, hyperactivity and impulsivity. Patients with at least three scores < - 1.5 standard deviations were considered as positive to MOXO-continuous performance test. Test scores of the pre-dialysis chronic kidney disease, dialysis (divided into peritoneal dialysis and hemodialysis subgroups) and kidney transplantation groups were compared. Correlations of test scores with the patient's clinical and laboratory characteristics and effects of hospitalizations and schooling were assessed.
Seventy-two patients aged 13.3 ± 3.4 years (23 with kidney transplantation, 23 on dialysis and 26 with pre-dialysis chronic kidney disease) were evaluated. Overall MOXO-continuous performance test positivity was 29%. No differences were detected between the three groups concerning total or z scores. Attention and timeliness z scores were significantly higher in females (p = 0.004 and p = 0.008, respectively). Age was positively correlated to attention and timeliness total scores (p = 0.000, r = 0.445 and p = 0.004, r = 0.243, respectively), and inversely correlated to hyperactivity total scores (p = 0.000, r = - 0.415).
Prevalence of attention-deficit hyperactivity disorder-like symptoms in the study population was much higher than that of pediatric attention-deficit hyperactivity disorder. We believe that the MOXO-continuous performance test is a valid supportive measure for evaluation of attention-deficit hyperactivity disorder diagnosis in children with various stages of chronic kidney disease or on kidney replacement therapy.
患有慢性肾脏疾病并接受肾脏替代治疗的儿童可能存在神经认知和社会心理障碍。尽管肾移植可以提高生活质量，但接受肾移植的儿童可能存在心理问题。在此，我们旨在研究接受透析和肾移植的慢性肾脏病、透析前儿童的注意缺陷多动障碍样症状。
MOXO 连续性能测试测量注意缺陷多动障碍样症状的四个领域，包括注意力、及时性、多动和冲动。至少有三个分数<-1.5 个标准差的患者被认为 MOXO 连续性能测试阳性。比较了透析前慢性肾脏病、透析（分为腹膜透析和血液透析亚组）和肾移植组的测试分数。评估测试分数与患者的临床和实验室特征以及住院和上学的影响之间的相关性。
共评估了 72 名年龄为 13.3±3.4 岁的患者（23 名接受肾移植，23 名接受透析，26 名接受透析前慢性肾脏病）。MOXO 连续性能测试阳性率为 29%。三组间总评分或 z 评分无差异。女性注意力和及时性 z 评分显著更高（p=0.004 和 p=0.008）。年龄与注意力和及时性总分呈正相关（p=0.000，r=0.445 和 p=0.004，r=0.243），与多动总分呈负相关（p=0.000，r=-0.415）。
研究人群中注意缺陷多动障碍样症状的患病率远高于儿科注意缺陷多动障碍。我们认为，MOXO 连续性能测试是评估各种慢性肾脏病或接受肾脏替代治疗的儿童注意缺陷多动障碍诊断的有效支持性措施。
