Abstract

Background and Aim: Chronic kidney disease (CKD) is often associated with a variety of
cognitive deficits. This will have significant lifelong implications. Therefore, we measure the
clinical predictors of cognitive impairment.
Methods: This cross-sectional study was conducted in a third-level hospital from October
2017 to December 2018. A total of 41 patients with CKD stage III to V and V on dialysis,
aged 6 to 14 years of both sexes were included in this study. CKD was staged according to
the estimated glomerular filtration rate (eGFR). The Wechsler intelligence scales for childrenrevised
(WISC-R) were provided as an individualized measure of verbal and performance
abilities. Then individual score was compared among the study population.
Results: A total of 41 patients were studied. The Mean±SD age was 10.35±2.19 years. The
majority were male (56%) and the male-to-female ratio was 1.3:1. Full-scale intelligence
quotient (IQ) deficits were found in 31 patients (75.6%) and most of them had mild cognitive
deficits (96.8%). Among them, verbal IQ deficit was found in 7 patients (17.1%), performance
IQ deficit in 6(14.6%), and combined IQ deficit in 18(43.9%). IQ score did not depend on
the severity of the disease. The duration of the disease was longer and the age at initiation
of renal replacement therapy (RRT) was lower, for those with the cognitive deficit, was not
significant. School attendance and performance were significantly poor in cognitive deficit
patients but anemia and hypertension had no significant impact.
Conclusion: The mild cognitive deficit was often associated with childhood CKD but not
related to the severity of the disease. Therefore, the cognitive function should be routinely
screened and monitored during the evaluation of children with CKD.