Cognitive and psychosocial outcome of infants dialysed in infancy

• Published in: Child : care, health & development health & development, 2003-01, Vol.29 (1), p.55-61
• Main Authors: Madden, S.J., Ledermann, S.E., Guerrero‐Blanco, M., Bruce, M., Trompeter, R.S.
• Format: Article
• Language: English
• Subjects: Adolescent; Babies; Brain; Child; Child Development; Child, Preschool; cognitive and psychological outcome; Cognitive Development; Developmental Delays; Dialysis; dialysis treatment; Emotional Problems; end‐stage renal failure from infancy; Family Characteristics; Family life; Hospitals; Humans; impact on family lifestyle; Infant; Infant, Newborn; Intelligence; Intelligence Quotient; Kidney failure; Kidney Failure, Chronic - psychology; Kidney Failure, Chronic - therapy; Long term effects; Longitudinal Studies; Outcome Measures; Peritoneal Dialysis - psychology; Psychological development; Psychometrics; Social Adjustment; Young Children
• ISSN: 0305-1862; 1365-2214
• DOI: 10.1046/j.1365-2214.2003.00311.x

Objective   To contribute further to the understanding of cognitive and psychosocial outcome of children with end‐stage renal disease undergoing long‐term peritoneal dialysis. Methods   In total, 16 surviving infants at a single centre beginning peritoneal dialysis in the first year of life were studied. The age range of the children at assessment was 1.6–12.1 years. Children were assessed using the Griffiths Mental Development Scales, the Wechsler Intelligence Scale for Children – Third Edition UK, and the Strengths and Difficulties Questionnaire. Information regarding the child's hospital stay and family background was also collated. A Pearson's Product Moment correlation was used to analyse the results. Results   Although 67% of the children's scores fell within the average range, 87% were within at least two SDs of the norms (mean IQ = 86.6). Psychosocial adjustment measures revealed that 50% of scores fell within the borderline to abnormal category, suggesting that the frequency of psychological difficulties was above that of the normal population. Conclusions   These findings lend support to recent studies indicating that, developmentally, children undergoing long‐term peritoneal dialysis are faring better than in the past. This may indeed be a reflection of improvements in renal treatment and diet. The behavioural results suggest the need to monitor psychological adjustment in this group of children.