This study examines the early neurodevelopmental function of infants and preschool children who have chronic kidney disease (CKD). Fifteen patients with CKD are compared to a healthy control group using the Mullen Scales of Early Learning (MSEL) and the Vineland Adaptive Behavior Scale (VABS). Multivariate analysis reveals significant differences between the CKD and control groups on both MSEL (p < .01) and VABS (p < .001) composite scales, with the group with CKD obtaining lower scores on both composites. A higher proportion of children with CKD meet federal eligibility criteria for early cognitive delay, but similar proportions are found across adaptive behaviors. Disease severity is positively correlated to cognitive and adaptive functioning such that lower scores are associated with less renal function (MSEL r = .62, p < .001; VABS r = .70, p < .001). Suggestions are made in regard to special education assessment and service provision.
Andreoli, S.P., Bergstein, J.M., & Sherrard, D.J. (1984). Aluminum intoxication from aluminum-containing phosphate binders in children with azotemia not undergoing dialysis. New England Journal of Medicine, 310, 1079-1084.
2.
Bale, J.F., Siegler, R.L., & Bray, P.F. (1980). Encephalopathy in young children with moderate chronic renal failure. American Journal of Diseases of Children , 134, 581-583.
3.
Baluarte, H.J., Gruskin, A.B., Hiner, L.B., Foley, C.M., & Grover, W.D. (1977). Encephalopathy in children with chronic renal failure. Proceedings of the Clinical Dialysis and Transplant Forum, 7, 95-98.
4.
Bird, A.K., & Semmler, C.J. (1986). The early developmental and neurologic sequelae of children with kidney failure treated by CAPD/CCPD. Pediatric Research, 20, 446A.
5.
Bock, G.H., Conners, C.K., Ruley, J., Samango-Sprouse, C.A., Conry, J.A., Weiss, I., et al. (1989). Disturbances of brain maturation and neurodevelopment during chronic renal failure in infancy. Journal of Pediatrics , 114, 231-238.
6.
Brouhard, B.H., Donaldson, L.A., Lawry, K.W., McGowan, K.R., Drotar, D., Davis, I., et al. (2000). Cognitive functioning in children on dialysis and post-transplantation. Pediatric Transplantation, 4, 261-267.
7.
Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Lawrence Erlbaum.
8.
Conley, S.B. (1987). Supplemental (NG) feedings of infants undergoing continuous peritoneal dialysis. In R. N. Fine (Ed.), Chronic ambulatory peritoneal dialysis (CAPD) and chronic cycling peritoneal dialysis (CCPD) in children (pp. 263-269). Boston: Nijhoff.
9.
Davis, I., Chang, P., & Nevins, T. (1990). Successful renal transplantation accelerates development in young uremic children. Pediatrics, 86, 594-600.
10.
Duquette, P.J., Hooper, S.R., Wetherington, C.E., Jenkins, T.L., & Gipson, D.S. (2007). Intellectual functioning and academic achievement in pediatric chronic kidney disease. Journal of Pediatric Psychology, 32, 1011-1017.
11.
Elzouki, A., Carroll, J., Butinar, D., & Moosa, A. (1994). Improved neurological outcome in children with chronic renal disease from infancy. Pediatric Nephrology, 8, 205-210.
12.
Geary, D.F., & Haka-Ikse, K. (1989). Neurodevelopmental progress of young children with chronic renal failure. Pediatrics, 84, 68-72.
13.
Gipson, D.S., Wetherington, C.E., Duquette, P.J., & Hooper, S.R. (2004). The nervous system and chronic kidney disease in children. Pediatric Nephrology, 19, 832-839.
14.
Groothoff, J.W. (2005). Long-term outcomes of children with end-stage renal disease. Pediatric Nephrology, 20, 849-853.
15.
Hulstijn-Dirkmaat, G.M., Damhuis, I.H., Jetten, M.L., Koster, A.M., & Schroder, C.H. (1995). The cognitive development of pre-school children treated for chronic renal failure. Pediatric Nephrology, 9, 464-469.
16.
Individuals With Disabilities Education Improvement Act, 20 U.S.C § 1401 et seq. (2006).
17.
Kari, J.A., Gonzalez, C., Ledermann, S.E., Shaw, V., & Rees, L. (2000). Outcome and growth of infants with severe chronic renal failure. Kidney International, 57, 1681-1687.
18.
Lande, M.B., Kaczorowski, J.M., Auinger, P., Schwartz, G.J., & Weitzman, M. (2003). Elevated blood pressure and decreased cognitive function among school-age children and adolescents in the United States. Journal of Pediatrics, 143, 720-724.
19.
Madden, S.J., Ledermann, S.E., Guerrero-Blanco, M., Bruce, M., & Trompeter, R.S. (2003). Cognitive and psychosocial outcome of infants dialysed in infancy. Child: Care, Health, and Development, 29, 55-61.
20.
Mantel, N., & Haenszel, W. (1959). Statistical aspects of the analysis of data from retrospective studies of disease. Journal of the National Cancer Institute, 22, 719-748.
21.
Marsh, J.T., Brown, W.S., Wolcott, D., Carr, C.R., Harper, R., Schweitzer, S.V., et al. (1991). rHuEPO treatment improves brain and cognitive function of anemic dialysis patients. Kidney International , 39, 155-163.
22.
McGraw, M.E., & Haka-Ikse, K. (1985). Neurologic-developmental sequelae of chronic renal failure in infancy. Journal of Pediatrics, 106, 579-583.
23.
National Kidney Foundation. (2001). K/DOQI clinical practice guidelines for nutrition in chronic renal failure . American Journal of Kidney Disease, 37(1 Suppl. 2), S66-S70.
24.
National Kidney Foundation. (2002). K/DOQI clinical practice guidelines for chronic kidney disease: Evaluation, classification, and stratification. American Journal of Kidney Disease, 39(2 Suppl. 1), S1-S266.
25.
Polinsky, M.S., Kaiser, B.A., Stover, J.B., Frankenfield, M., & Baluarte, H.J. (1987). Neurologic development of children with severe chronic renal failure from infancy. Pediatric Nephrology, 1, 157-165.
26.
Qvist, E., Pihko, H., Fagerudd, P., Valanne, L., Lamminranta, S., Karikoski, J., et al. (2002). Neurodevelopmental outcome in high-risk patients after renal transplantation in early childhood. Pediatric Transplant, 6, 53-62.
27.
Rotundo, A., Nevins, T.E., Lipton, M., Lockman, L.A., Mauer, S.M., & Michael, A.F. (1982). Progressive encephalopathy in children with chronic renal insufficiency in infancy. Kidney International, 21, 486-491.
28.
Schwartz, G.J., Brion, L.P., & Spitzer, A. (1987). The use of plasma creatinine concentration for estimating glomerular filtration rate in infants, children, and adolescents . Pediatric Clinics of North America, 34, 571-590.
29.
Sedman, A.B., Miller, N.L., Warady, B.A., Lum, G.M., & Alfrey, A.C. (1984). Aluminum loading in children with chronic renal failure. Kidney International, 26, 201-204.
30.
So, S.K., Change, P.N., Najarian, J.S., Mauer, S.M., Simmons, R.L., & Nevins, T.E. (1987). Growth and development in infants after renal transplantation. Journal of Pediatrics, 110, 343-350.
31.
Van Dyck, M., & Proesmans, W. (2001). Growth hormone therapy in chronic renal failure induces catch-up of head circumference. Pediatric Nephrology , 16, 631-636.
32.
Warady, B.A. (2002). Neurodevelopment of infants with end-stage renal disease: Is it improving? Pediatric Transplantation, 6, 5-7.
33.
Warady, B.A., Belden, B., & Kohaut, E. (1999). Neurodevelopmental outcome of children initiating peritoneal dialysis in early infancy. Pediatric Nephrology , 13, 759-765.
34.
Winick, M. (1969). Malnutrition and brain development. Journal of Pediatrics, 74, 667-679.
