Chronic kidney disease in children affects brain development
Researchers have observed differences in brain structure in children with chronic kidney disease (CKD) compared to children without CKD. CKD is characterized by a reduced ability of kidneys to filter blood the way that they should over an extended period of time. Diabetes and high blood pressure are the leading causes of CKD in adults. However, the most common causes of CKD in children are kidney birth defects or genetic diseases. Deficits in mental function are often associated with CKD in pediatric patients, with children displaying difficulties concentrating, learning, and remembering. While these cognitive deficits are known to manifest, there have been very few brain-imaging studies to determine their cause.
In this study, researchers used a brain imaging technology called diffusion weighted magnetic resonance imaging to view the integrity of tissues deep in the brain known as white matter. The researchers compared brain scans of 17 boys with CKD (ages 6 to 16) to 20 healthy boys (ages 7 to 16). Their aim was to identify differences between the groups and to discern their potential links to cognitive deficits in those with CKD. The analysis revealed reduced white matter integrity in children with CKD that mapped to multiple distinct brain regions when compared to children without CKD. The scientists did not, however, find that the observed decrease in white brain matter integrity correlated with cognitive deficits. In fact, the researchers observed that, among the children with CKD, there was an unexpected potential association between higher white brain matter integrity and decreased executive functions (mental processes directing a child’s thought, action, and emotion during problem solving).
This study suggests that there are differences in the brains of children with CKD compared to children without the disease. Further research on a larger number of children, including girls as well as boys, may provide insight into whether white matter differences contribute to the cognitive deficits observed in children living with CKD and whether the correlations observed in this study are truly representative of the population.
van der Plas E, Solomon MA, Hopkins L, …Harshman LA. Global and regional white matter fractional anisotropy in children with chronic kidney disease. J Pediatr 242: 166-173, 2022.