Neurodevelopmental Outcomes in Early Childhood Chronic Kidney Disease: Evidence from a Case-control Study

Background: Children with chronic kidney disease (CKD) are at risk of inferior neurocognitive outcomes. As the brain develops rapidly during the early years of life, we wanted to find out the impact of CKD on neurocognition when it occurs during this time and any disease-associated risk factors. Methods: A cross-sectional case-control study was conducted in the Paediatric Nephrology Clinic, PGIMER, Chandigarh. After obtaining parental consent, 52 children with CKD Stage 3-5 and 52 age-matched case controls were enrolled in the study. Neurocognitive outcome was assessed by the Developmental Assessment Scales for Indian Infants (DASII). Proper statistical tests were used to analyse the data. Results: Mean comparison revealed that CKD children performed significantly lower on mental functions, motor functions and developmental quotient of DASII. Neurocognitive functions declined with disease progression, with children of CKD Stage 5 scoring lowest. Further, there was a significant difference in weight, height/length and head circumference between those in Stage 3 and 5. Similarly, there are significant mean differences in Hb, MCH, and MCHC levels between Stage 3 and both Stage 4 and 5, but no significant difference between those in Stage 4 and 5. Conclusion: CKD is a debilitating condition that can have a significant impact on the health and development of children. Neurocognitive outcome declines as the stage of CKD progresses, which worsens their overall outcomes.