The Effects of Pediatric Renal Transplantation on Neurocognitive Function

Abstract

Introduction: Neurocognitive dysfunction is one of the major complications of chronic renal failure (CRF). Uremic state during CRF encompasses a wide spectrum of neurobehavioral and neurological disturbances. Recent studies showed that the pathophysiology of neurocognitive dysfunction in CRF is related with plasma levels of uremic solutes. Successful renal transplantation improves renal, metabolic and endocrine functions and the quality of life. The aim of our study is to determine the state of neurocognitive function in pediatric renal transplantation recipients. Methods: We prospectively performed a neurological examination and neuropsychological test battery (Bender-Gestalt Test, Cancellation Test, Visual and Auditory Number Assay Test) in 20 pediatric renal transplant recipients between 6 and 16 years old. Twenty healthy children were included to the study as the control group. Mean age of the renal transplant recipients was 13.50±3.40 years old. Mean evaluation time after transplantation was 2.0±0.5 years. Results: Bender-Gestalt Test was in abnormal in 40% of patients. The results of the Cancellation Test and Visual and Auditory Number Assay Test showed significant decline in pediatric renal transplant patients when compared with the control. We found that neurocognitive dysfunction was frequent in pediatric renal transplantation patients. Conclusion: Awareness of this potential problem may be helpful to early recognition and treatment. Our findings suggest that periodic neurocognitive assessments may be indicated in transplanted patients.