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Depression and neurocognitive dysfunction in pediatric and young adult chronic kidney disease

  • Amy J. KogonEmail author
  • Ji Young Kim
  • Nina Laney
  • Jerilynn Radcliffe
  • Stephen R. Hooper
  • Susan L. Furth
  • Erum A. Hartung
Original Article
Part of the following topical collections:
  1. What’s New in Chronic Kidney Disease

Abstract

Background

Depression affects 7–35% of children with chronic kidney disease (CKD), and in adults with CKD, the presence of depression links to poorer medical outcomes, social functioning difficulties, and neurocognitive impairments. The relationship between depression and neurocognitive function in youth with CKD is unclear. We sought to identify factors associated with depression in youth with CKD and to determine whether depression affects neurocognitive performance.

Methods

We conducted cross-sectional analyses in 71 CKD and 64 control participants aged 8 to 25 years who completed depression inventories and neurocognitive assessments as part of the Neurocognitive Assessment and Magnetic Resonance Imaging Analysis of Children and Young Adults with CKD Study. In the CKD group, multivariable logistic regression analysis determined associations between clinical and demographic factors and depression. In the full study cohort, multivariable linear regression analyses, including an interaction term between CKD status and depression evaluated the effect of depression on 11 neurocognitive outcome domains.

Results

Obesity significantly associated with depression in the CKD group (OR 10.25, P = 0.01). In adjusted analyses, depressed youth with CKD scored worse than non-depressed CKD participants by 0.6–1.0 standard deviations in 5 neurocognitive domains: attention, visual memory, visual-spatial, visual working memory, and problem solving.

Conclusions

CKD youth with obesity are more likely to be depressed, and those who are depressed exhibit worse neurocognitive performance. Depression may represent a therapeutic target to improve neurocognitive performance in youth with CKD.

Keywords

Pediatric Dialysis Transplant Renal disease Depression Neurocognition 

Abbreviations

(CKD)

Chronic kidney disease

(CKiD)

Chronic kidney disease in children

(GFR)

Glomerular filtration rate

(NiCK)

The Neurocognitive Assessment and Magnetic Resonance Imaging Analysis of Children and Young Adults with Chronic Kidney Disease

(eGFRs)

Estimated GFRs

(MDRD)

Modification of diet in renal disease

(CDI-II)

Children’s Depression Inventory-II

(BDI-II)

Beck Depression Inventory-II

(WASI)

Wechsler Abbreviated Scales of Intelligence

(CPT-II)

Conners’ Continuous Performance Test-II

(WISC-IV-I)

Wechsler Intelligence Scale for Children Fourth Edition Integrated

(WMS-III)

Wechsler Memory Scale Third Edition

(BRIEF)

Executive functioning Behavior Rating Inventory of Executive Function

(D-KEFS)

Delis-Kaplan Executive Function System

(ESRD)

End-stage renal disease

Notes

Funding source

This project was funded in part under a Commonwealth Universal Research Enhancement grant with the Pennsylvania Department of Health, no. SAP 4100054843. The Department specifically disclaims responsibility for any analyses, interpretations, or conclusions. The funders did not have any role in study design, data collection, data analysis, writing of the report, or the decision to submit the report for publication.

Financial disclosure

The authors have no financial relationships relevant to this article to disclose.

Compliance with ethical standards

The Institutional Review Board at the Children’s Hospital of Philadelphia (CHOP) approved this study, and informed consent was obtained from all participants.

Conflict of interest

The authors declare that they have no conflict of interest.

No reprints requested.

Supplementary material

467_2019_4265_MOESM1_ESM.docx (13 kb)
Table S1 (DOCX 12 kb)
467_2019_4265_MOESM2_ESM.docx (13 kb)
Table S2 (DOCX 13 kb)

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Copyright information

© IPNA 2019

Authors and Affiliations

  • Amy J. Kogon
    • 1
    • 2
    Email author
  • Ji Young Kim
    • 3
  • Nina Laney
    • 4
  • Jerilynn Radcliffe
    • 2
    • 5
  • Stephen R. Hooper
    • 6
  • Susan L. Furth
    • 1
    • 2
  • Erum A. Hartung
    • 1
    • 2
  1. 1.Division of NephrologyChildren’s Hospital of PhiladelphiaPhiladelphiaUSA
  2. 2.Department of PediatricsPerelman School of Medicine at the University of PennsylvaniaPhiladelphiaUSA
  3. 3.Biostatistics Core, the Center for Human Phenomic ScienceChildren’s Hospital of PhiladelphiaPhiladelphiaUSA
  4. 4.Lifespan Brain Institute, Department of Child and Adolescent Psychiatry and Behavioral SciencesChildren’s Hospital of PhiladelphiaPhiladelphiaUSA
  5. 5.Division of Developmental and Behavioral PediatricsChildren’s Hospital of PhiladelphiaPhiladelphiaUSA
  6. 6.Department of Allied Health SciencesSchool of Medicine University of North Carolina Chapel HillChapel HillUSA

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