A new study found that children affected with chronic kidney disease (CKD) are more prone to face problems related to attention, visual, and verbal memory, besides their deteriorating physical health. In children, genetic causes account for the highest number of kidney disease. Published in the Clinical Journal of the American Society of Nephrology, the research reveals that children with CKD are at a greater risk of shortfalls in academic skills, visual, verbal memory and executive function.

The investigation included 34 studies of over 3000 children and adolescents under the age of 21 years. The Lead author Dr Kerry Chen of the University of Sydney’s Centre for kidney Research states that “the IQ of children with CKD is low to average” compared to healthy children. Children with CKD were on average 10 IQ points lesser irrespective of their stage of kidney disease. Children who had kidney transplant were 11 points lesser than their healthy counterparts and those on dialysis were 16 IQ points lower.

The results of this study review suggest that academic support may be required in specific areas including math and reading.

How chronic kidney disease and dialysis affect IQ and educational outcomes?

The evidence is not conclusive, but experts believe that there might be some correlation that affects the IQ and educational outcomes in children and young adults affected by chronic kidney disease.

The Lead author Dr. Kerry Chen states, “Elevated plasma uremic solutes levels due to kidney disease may impair synaptic development that leads to cognitive impairment through quick changes in blood pressure.”

The clinical effects associated with CKD such as anemia, hypertension, and malnutrition may lower cognitive function among children on dialysis compared to other CKD stages.

In addition to that, treatments for CKD may undermine academic achievement. Initially, the frequency of sleep disturbances in children with CKD may result in poor concentration, extreme daytime sleepiness and reduce academic performance.

Furthermore, the interactions of complex medication practices and strict dialysis phases may lower the ability to concentrate & pay attention for any length of time, working memory, and executive function- cognitive areas that are vital to children’s ability to acquire, understand and retain information in social and educational environments.

Lastly, ongoing dialysis sittings and recovery from transplant surgeries may reduce the regularity of time spent in the classroom, with frequent absenteeism possibly preceding loss of interest, withdrawal, and poor school progression.

What can be done?

Special education support programs should particularly aim to reduce deficits in attention, memory, and executive function as a preventive measure states Dr. Chen.

Families, educator and health care team also need to work jointly to ensure that CKD treatments for children do not disturb their schooling too much or too often. Developing comprehensive dialysis and post-transplant rehabilitation program would help these children.

Dr. Kerry Chen lead author works at the University of Sydney's School of Public Health, The Kids Research Institute and Westmead Hospital.