To investigate the associations between neurocognition and white matter integrity in children with chronic kidney disease.
This cross-sectional study included 17 boys (aged 6-16 years) with a diagnosis of mild to moderate (stages 1-3, non-dialysis/non-transplant) CKD due to congenital anomalies of the kidney and urinary tract and 20 typically developing community controls. Participants underwent 3T neuroimaging and diffusion-weighted magnetic resonance imaging to assess white matter fractional anisotropy. Multivariable linear regression models were used to evaluate the impact of each group (controls vs. CKD) on white matter fractional anisotropy, adjusting for age. Associations between white matter fractional anisotropy and neurocognitive abilities within the CKD group were also evaluated using regression models that were adjusted for age. The false discovery rate was used to account for multiple comparisons; wherein false discovery values <0.10 were considered significant.
Global white matter fractional anisotropy was reduced in CKD patients relative to controls (standardized estimate [SE]= -0.38, 95% confidence interval [CI] -0.69:-0.07), driven by reductions within the body of the corpus callosum (SE = -0.44, 95% CI -0.75:-0.13), cerebral peduncle (SE = -0.37, 95% CI -0.67:-0.07), cingulum (hippocampus) (SE = -0.45, 95% CI -0.75:-0.14), and posterior limb of the internal capsule (SE = -0.46, 95% CI -0.76:-0.15). Medical variables and neurocognitive abilities were not significantly associated with white matter fractional anisotropy.
White matter development is vulnerable in children with CKD due to congenital causes, even prior to the need for dialysis or transplantation.

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