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Neurocognitive and functional outcomes at 5 years of age after renal transplant in early childhood

  • Jillian Popel
  • Rachel Joffe
  • Bryan V. Acton
  • Gwen Y. Bond
  • Ari R. Joffe
  • Julian Midgley
  • Charlene M. T. Robertson
  • Reg S. Sauve
  • Catherine J. MorganEmail author
Original Article

Abstract

Background

Clinicians often use information about developmental outcomes in decision-making around offering complex, life-saving interventions in children such as dialysis and renal transplant. This information in children with end-stage renal disease (ESRD) is limited, particularly when ESRD onset is in infancy or early childhood.

Methods

Using data from an ongoing prospective, longitudinal, inception cohort study of children with renal transplant before 5 years of age, we evaluated (1) the risk of adverse neurocognitive and functional outcomes at 5 years of age and (2) predictors of developmental outcomes.

Results

We found evidence of neurocognitive sequelae of ESRD in very young children; however, developmental outcomes appear remarkably better when compared with findings of two or three decades ago. Less time on dialysis predicted higher developmental scores, and hemodialysis was associated with poorer developmental outcomes.

Conclusions

Our data suggest that renal replacement therapies in young children are associated with acceptable developmental outcome. Programs to identify those with developmental delays and provide early intervention may allow achievement of the child’s full potential.

Keywords

Renal transplant Children Development Outcome Neurocognitive 

Notes

Author contributions

All authors made substantial contribution to the study and paper: C. Morgan, J. Popel, C. Robertson, and G. Bond—research design, data acquisition, data analysis, and interpretation of results; J. Popel, R. Joffe, and C. Morgan—data acquisition and drafting the paper; J. Midgley and R. Sauve—data acquisition; A. Joffe and B. Acton—interpretation of results. All authors have revised the paper critically and approved the final version for submission.

Compliance with ethical standards

The project was approved by local health research ethics boards. All parents/guardians provided informed consent for follow-up and participation in the program.

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© IPNA 2018

Authors and Affiliations

  • Jillian Popel
    • 1
  • Rachel Joffe
    • 1
  • Bryan V. Acton
    • 2
  • Gwen Y. Bond
    • 3
  • Ari R. Joffe
    • 1
  • Julian Midgley
    • 4
  • Charlene M. T. Robertson
    • 5
    • 1
  • Reg S. Sauve
    • 6
    • 7
  • Catherine J. Morgan
    • 1
    Email author
  1. 1.Department of Pediatrics, Edmonton Clinic Health AcademyUniversity of AlbertaEdmontonCanada
  2. 2.Royal University HospitalUniversity of SaskatchewanSaskatoonCanada
  3. 3.Stollery Children’s HospitalUniversity of AlbertaEdmontonCanada
  4. 4.Division of Pediatric Nephrology, Department of Pediatrics, Cumming School of MedicineUniversity of CalgaryCalgaryCanada
  5. 5.Glenrose Rehabilitation HospitalEdmontonCanada
  6. 6.Alberta Children’s HospitalCalgaryCanada
  7. 7.Department of PediatricsUniversity of CalgaryCalgaryCanada

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