Depression and neurocognitive dysfunction in pediatric and young adult chronic kidney disease.

TitleDepression and neurocognitive dysfunction in pediatric and young adult chronic kidney disease.
Publication TypeJournal Article
Year of Publication2019
AuthorsKogon AJ, Kim JYoung, Laney N, Radcliffe J, Hooper SR, Furth SL, Hartung EA
JournalPediatr Nephrol
Volume34
Issue9
Pagination1575-1582
Date Published2019 09
ISSN1432-198X
KeywordsAdolescent, Adult, Child, Cognitive Dysfunction, Cohort Studies, Cross-Sectional Studies, Depression, Female, Glomerular Filtration Rate, Humans, Magnetic Resonance Imaging, Male, Neuropsychological Tests, Obesity, Prevalence, Renal Insufficiency, Chronic, Risk Factors, Young Adult
Abstract

BACKGROUND: Depression affects 7-35% of children with chronic kidney disease (CKD), and in adults with CKD, the presence of depression links to poorer medical outcomes, social functioning difficulties, and neurocognitive impairments. The relationship between depression and neurocognitive function in youth with CKD is unclear. We sought to identify factors associated with depression in youth with CKD and to determine whether depression affects neurocognitive performance.

METHODS: We conducted cross-sectional analyses in 71 CKD and 64 control participants aged 8 to 25 years who completed depression inventories and neurocognitive assessments as part of the Neurocognitive Assessment and Magnetic Resonance Imaging Analysis of Children and Young Adults with CKD Study. In the CKD group, multivariable logistic regression analysis determined associations between clinical and demographic factors and depression. In the full study cohort, multivariable linear regression analyses, including an interaction term between CKD status and depression evaluated the effect of depression on 11 neurocognitive outcome domains.

RESULTS: Obesity significantly associated with depression in the CKD group (OR 10.25, P = 0.01). In adjusted analyses, depressed youth with CKD scored worse than non-depressed CKD participants by 0.6-1.0 standard deviations in 5 neurocognitive domains: attention, visual memory, visual-spatial, visual working memory, and problem solving.

CONCLUSIONS: CKD youth with obesity are more likely to be depressed, and those who are depressed exhibit worse neurocognitive performance. Depression may represent a therapeutic target to improve neurocognitive performance in youth with CKD.

DOI10.1007/s00467-019-04265-z
Alternate JournalPediatr. Nephrol.
PubMed ID31049719