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小儿肾移植候选者的神经认知功能障碍:医学和社会人口学因素

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

作者信息

Gu Lidan, Anzalone Christopher J, Kane-Grade Finola, Glad Danielle, Evans Michael, Kizilbash Sarah

机构信息

Division of Clinical Behavioral Neuroscience, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, United States.

Department of Psychiatry and Behavioral Sciences, Boston Children's Hospital, Harvard Medical School.

出版信息

Appl Neuropsychol Child. 2024 Dec 4:1-10. doi: 10.1080/21622965.2024.2436599.

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, .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 (s < .001). After adjusting for covariates, patients with congenital anomalies of the kidney and urinary tract ( = 87; 95% : 80-94) and other etiologies ( = 82; 95% CI: 76-89) had significantly lower processing speed compared to patients with nephrotic syndrome ( = 98; 95% CI: 89-107) ( = .02). Patients living in high-level deprivation neighborhoods showed significantly lower verbal skills ( = .01), working memory performance ( = .02), and full-scale IQ ( = .03) than patients living in median-level and low-level deprivation neighborhoods. Additionally, dialysis did not show significant association with neurocognitive domains ((s ranged from .07 to .52).

摘要

我们评估了肾衰竭病因、透析和地区贫困指数对儿科肾移植候选者神经认知功能子领域的影响。该研究纳入了78名儿科肾移植候选者(47.4%为男性,70.5%为白人,年龄 = 11.77岁,51.3%的患者有公共保险),他们在2010年1月1日至2022年10月31日期间完成了移植前神经心理学评估。采用线性回归模型进行数据分析。儿科肾移植候选者各神经认知功能领域的平均得分显著低于一般人群(s <.001)。在对协变量进行调整后,与肾病综合征患者(= 98;95%置信区间:89 - 107)相比,患有肾脏和尿路先天性异常的患者(= 87;95%置信区间:80 - 94)以及其他病因的患者(= 82;95%置信区间:76 - 89)的处理速度显著较低(= .02)。与生活在中等贫困水平和低贫困水平社区的患者相比,生活在高贫困水平社区的患者的语言技能(= .01)、工作记忆表现(= .02)和全量表智商(= .03)显著较低。此外,透析与神经认知领域未显示出显著关联(s范围为.07至.52)。

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