RT Journal Article
SR Electronic
T1 Impaired cognition and schooling in adults with end stage renal disease since childhood
JF Archives of Disease in Childhood
JO Arch Dis Child
FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
SP 380
OP 385
DO 10.1136/adc.87.5.380
VO 87
IS 5
A1 J W Groothoff
A1 M Grootenhuis
A1 A Dommerholt
A1 M P Gruppen
A1 M Offringa
A1 H S A Heymans
YR 2002
UL http://adc.bmj.com/content/87/5/380.abstract
AB Aims: To determine cognitive and educational attainment in adults with end stage renal disease (ESRD) since childhood. Methods: All Dutch patients with onset of ESRD at age 0–14 years between 1972 and 1992, who were born before 1979, were asked to perform the Wechsler Adult Intelligence Scale (WAIS) test. Educational attainment was assessed by a questionnaire. Determinants of cognitive performance were measured by reviewing medical charts in 37 hospitals. Data on cognition were compared to those of age matched controls who cooperated in the revision of the Dutch WAIS. National Dutch Statistics data were used to compare educational attainment. Results: Data on intelligence and schooling were acquired in 126 of 187 patients (67%) and data on determinants of outcome in all patients. Clinical characteristics of participants and non-participants were comparable. Educational attainment of patients was low compared to the Dutch standard. Patient mean full scale IQ, performal IQ, and verbal IQ were 10.4, 9.2, and 9.7 points lower, respectively, compared to those of 36 controls. The lowest scores were observed in tasks which require concentration, memory, and general knowledge. Patients currently on dialysis and transplanted patients had similar IQ scores. Cumulative dialysis duration of more than four years was associated with a 3.4 times higher chance of having a full scale IQ of 1 SD below the mean. Conclusion: ESRD of childhood is associated with an impaired cognitive and educational attainment in adulthood. Long duration of dialysis may enhance intellectual impairment, which may not be reversible after renal transplantation.