Resting-state EEG reveals slowing and altered functional connectivity in children and young adults with severe chronic kidney disease.

OBJECTIVE

Explore associations between quantitative markers of resting-state electroencephalography (EEG), severe chronic kidney disease (CKD), and neurocognition in children and young adults.

METHODS

We included 25 patients with CKD with an estimated glomerular filtration rate < 30 ml/min/1.73m2 aged 8-30 years, on different treatment modalities (pre-dialysis [n = 6], dialysis [n = 8], transplanted [n = 11]). EEG parameters of power spectrum analysis and functional connectivity were obtained using the Fourier transformation and amplitude envelope correlation (AEC) analysis, respectively. Neurocognition was measured using a comprehensive neurocognitive test battery. Mixed model analyses assessed relations between CKD parameters, EEG parameters and neurocognitive functions.

RESULTS

A longer time on dialysis in the past was significantly related to a higher delta and lower alpha power, which related to poorer Processing Speed and Working Memory. Patients on kidney replacement therapy had significantly higher delta AEC than pre-dialysis patients. A higher eGFR after transplantation was related to a higher delta AEC. Delta AEC was not related to neurocognitive performance.

CONCLUSION

Abnormal high delta power may be indicative of clinically apparent encephalopathy in young patients with kidney failure. The role of increased functional connectivity as potential compensatory mechanism should be further explored.

SIGNIFICANCE: Minimizing dialysis-time by early transplantation may be advantageous in the prevention of encephalopathy in young CKD patients.