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The brain in pediatric chronic kidney disease–the intersection of cognition, neuroimaging, and clinical biomarkers

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Abstract

Brain growth and development occur at peak rates in early childhood through adolescence, and for some children, this must happen in conjunction with chronic kidney disease (CKD), associated medical conditions, and their treatment(s). This review provides an overview of key findings to date on the topic of the brain in pediatric CKD. Here, we specifically address the topics of neuroimaging and cognition in pediatric CKD with consideration to biomarkers of disease progression that may impact cognition. Current cognitive data suggest that most children with mild to moderate CKD do not exhibit significant cognitive impairments, but, rather, the presence of somewhat lower intellectual abilities and subtle deficits in selected executive functions. Although promising, modern neuroimaging data remain inconclusive in linking cognitive findings to neuroimaging correlates in the pediatric CKD population. Certainly, it is important to note that even subtle cognitive concerns can present barriers to learning, social functioning, and overall quality of life if not appropriately recognized or addressed. Further longitudinal research utilizing concurrent and targeted cognitive and neuroimaging evaluations is warranted to better understand the impact of CKD progression on brain development and associated neurocognitive outcomes.

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Authors and Affiliations

  1. Stead Family Department of Pediatrics, Division of Nephrology, Dialysis & Transplantation, University of Iowa Stead Family Children’s Hospital, Iowa City, IA, USA

    Lyndsay A. Harshman

  2. Stead Family Department of Pediatrics, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, 4037 Boyd Tower, Iowa City, IA, 52242-1053, USA

    Lyndsay A. Harshman

  3. Department of Allied Health Sciences, School of Medicine, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA

    Stephen R. Hooper

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  1. Lyndsay A. Harshman
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Correspondence to Lyndsay A. Harshman.

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Answers 1. c, 2. d, 3. b, 4. d

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Harshman, L.A., Hooper, S.R. The brain in pediatric chronic kidney disease–the intersection of cognition, neuroimaging, and clinical biomarkers. Pediatr Nephrol 35, 2221–2229 (2020). https://doi.org/10.1007/s00467-019-04417-1

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