1. Neurocognitive and functional outcomes at 5 years of age after renal transplant in early childhood.
- Author
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Popel J, Joffe R, Acton BV, Bond GY, Joffe AR, Midgley J, Robertson CMT, Sauve RS, and Morgan CJ
- Subjects
- Alberta epidemiology, Child, Preschool, Cognitive Dysfunction diagnosis, Cognitive Dysfunction etiology, Cognitive Dysfunction prevention & control, Disease Progression, Female, Follow-Up Studies, Glomerular Filtration Rate, Humans, Infant, Infant, Newborn, Kidney Failure, Chronic complications, Kidney Failure, Chronic pathology, Longitudinal Studies, Male, Neuropsychological Tests statistics & numerical data, Prospective Studies, Registries statistics & numerical data, Risk Assessment methods, Risk Factors, Time Factors, Treatment Outcome, Child Development, Cognitive Dysfunction epidemiology, Kidney Failure, Chronic therapy, Kidney Transplantation, Renal Dialysis adverse effects
- 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.
- Published
- 2019
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