Depression and neurocognitive dysfunction in pediatric and young adult chronic kidney disease
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.
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.
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.
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.
KeywordsPediatric Dialysis Transplant Renal disease Depression Neurocognition
Chronic kidney disease
Chronic kidney disease in children
Glomerular filtration rate
The Neurocognitive Assessment and Magnetic Resonance Imaging Analysis of Children and Young Adults with Chronic Kidney Disease
Modification of diet in renal disease
Children’s Depression Inventory-II
Beck Depression Inventory-II
Wechsler Abbreviated Scales of Intelligence
Conners’ Continuous Performance Test-II
Wechsler Intelligence Scale for Children Fourth Edition Integrated
Wechsler Memory Scale Third Edition
Executive functioning Behavior Rating Inventory of Executive Function
Delis-Kaplan Executive Function System
End-stage renal disease
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.
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.
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