Cerebral metabolic alterations and cognitive dysfunction in children with chronic kidney disease using magnetic resonance spectroscopy and Wechsler intelligence scale.

AIM: Many studies have described impaired intelligence, attention, memory and executive function in patients with chronic kidney disease (CKD) dialyzed and non-dialyzed, but there is still a lack of sensitive and early methods of detection of these deficits. The purpose of this study was to investigate the relationship between brain metabolic alteration [measured by magnetic resonance spectroscopy (MRS)] and cognitive dysfunction in CKD children (detected by psychometric analysis).

METHODS: One hundred and forty patients with CKD were included (40 patients with stage 5 CKD on dialysis, 30 patients with stage 4 to 5 CKD without dialysis, and 70 patients with stage 1 to 3 CKD). All patients with previous neurological disorders were excluded. Conventional MRI, MRS and psychometric assessment using Wechsler intelligence scale for children third edition was done in all participants.

RESULTS: We found a significant negative correlation between MRS abnormalities and Wechsler IQ Test scores. But there was a significantly positive correlation between the CKD stages and MRS abnormalities in patients with CKD and negative significant correlation between CKD stages and Wechsler IQ test scores in patients with CKD. There were correlations between "the electrolyte disturbance, blood haemoglobin and hypertension" and "the CKD staging, cognitive functions IQ scores and MRS parameter changes".

CONCLUSION: It was concluded that both MRS and psychometric tests are sensitive methods for detection of impaired cognitive function in CKD children, particularly in the dialyzed group, and these findings appear before a clinical diagnosis.