Dataset Information

Association Between Chronic Kidney Disease-Mineral Bone Disease (CKD-MBD) and Cognition in Children: Chronic Kidney Disease in Children (CKiD) Study.

ABSTRACT:

Rationale & objective

Chronic kidney disease (CKD) in children is associated with cognitive dysfunction that affects school performance and quality of life. The relationship between CKD-mineral and bone disorder and cognitive function in children is unknown.

Study design

Observational study.

Participants

702 children enrolled in the Chronic Kidney Disease in Children (CKiD) Study.

Predictors

Plasma fibroblast growth factor 23 (FGF-23), parathyroid hormone (PTH), calcium, phosphorus, 25 hydroxyvitamin D (25[OH]D), and 1,25 dihydroxyvitamin D (1,25[OH]₂D).

Outcomes

Neurocognitive tests of intelligence, academic achievement, and executive functions.

Analytical approach

Linear regression models to analyze the cross-sectional associations between log₂FGF-23, 25(OH)D, 1,25(OH)₂D, PTH, calcium, and phosphorus z scores and the cognitive test scores of interest after adjustment for demographics, blood pressure, proteinuria, and kidney function.

Results

At baseline, median age was 12 (95% CI, 8.3, 15.2) years and estimated glomerular filtration rate was 54 (40.5, 67.8) mL/min/1.73 m². In fully adjusted analyses, 25(OH)D, 1,25(OH)₂D, PTH, calcium, and phosphorus z scores did not associate with cognitive test scores. In fully adjusted analyses, log₂FGF-23 was associated with abnormal test scores for attention regulation (P < 0.05); specifically, Conners' Continuous Performance Test II Errors of Omission (β = 2.3 [1.0, 3.6]), Variability (β=1.4 [0.4, -2.4]), and Hit Reaction Time (β = 1.3 [0.2, 2.4]). Children in the highest FGF-23 tertile group had 7% and 9% greater cognitive risk for Hit Reaction Time and Errors of Omission compared with those in the lowest tertile, respectively. In fully adjusted analyses, higher FGF-23 tertile was associated with increased cognitive risk (P < 0.05) for Errors of Omission (β = 0.4 [0.1, 0.7]) and Hit Reaction Time (β = 0.4 [0.1, 0.7]).

Limitations

The study does not assess the cumulative effects of FGF-23 excess on cognitive function over time. Within-population stratified analyses were not performed due to limited sample size.

Conclusions

In children with CKD, higher plasma FGF-23 level is associated with lower performance in targeted tests of executive function, specifically attention regulation, independent of glomerular filtration rate.

SUBMITTER: Yokoyama JS

PROVIDER: S-EPMC7406846 | biostudies-literature | 2020 Jul-Aug

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Association Between Chronic Kidney Disease-Mineral Bone Disease (CKD-MBD) and Cognition in Children: Chronic Kidney Disease in Children (CKiD) Study.

Yokoyama Jennifer S JS Matsuda-Abedini Mina M Denburg Michelle R MR Kumar Juhi J Warady Bradley A BA Furth Susan L SL Hooper Stephen R SR Portale Anthony A AA Perwad Farzana F

Kidney medicine 20200526 4

<h4>Rationale & objective</h4>Chronic kidney disease (CKD) in children is associated with cognitive dysfunction that affects school performance and quality of life. The relationship between CKD-mineral and bone disorder and cognitive function in children is unknown.<h4>Study design</h4>Observational study.<h4>Participants</h4>702 children enrolled in the Chronic Kidney Disease in Children (CKiD) Study.<h4>Predictors</h4>Plasma fibroblast growth factor 23 (FGF-23), parathyroid hormone (PTH), calc ...[more]

PMID: 32775979

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Dataset Information

Association Between Chronic Kidney Disease-Mineral Bone Disease (CKD-MBD) and Cognition in Children: Chronic Kidney Disease in Children (CKiD) Study.

Rationale & objective

Study design

Participants

Predictors

Outcomes

Analytical approach

Results

Limitations

Conclusions

Publications

Association Between Chronic Kidney Disease-Mineral Bone Disease (CKD-MBD) and Cognition in Children: Chronic Kidney Disease in Children (CKiD) Study.

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