Environmental lead exposure is associated with neurocognitive dysfunction in children with chronic kidney disease.
Background: Environmental lead exposure is associated with cognitive impairment in healthy children, with deficits seen in intelligence quotient (IQ), attention, and behavior. Neurocognitive dysfunction is also a well-described complication among children with chronic kidney disease (CKD). The objec...
| Published in: | Pediatric Nephrology Vol. 34; no. 11; pp. 2371 - 2380 |
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| Main Authors: | , , , , |
| Format: | research tables/charts Journal Article |
| Published: |
Springer Nature
Nov2019
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=139138156&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 139138156 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 0931041X EF1 jtl: Pediatric Nephrology issn: 0931041X maglogo: N pubinfo: dt: Nov2019 vid: 34 iid: 11 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 139138156 139138156 143923465 139138156 10.1007/s00467-019-04306-7 139138156 ppf: 2371 ppct: 9 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Environmental lead exposure is associated with neurocognitive dysfunction in children with chronic kidney disease. aug: au: Ruebner, Rebecca L. Hooper, Stephen R. Parrish, Carisa Furth, Susan L. Fadrowski, Jeffrey J. affil: Division of Pediatric Nephrology, Johns Hopkins University School of Medicine, 200 N Wolfe St, Room 3055, 21287, Baltimore, MD, USA sug: subj: Renal Insufficiency, Chronic Complications Lead Poisoning Complications Environmental Exposure Adverse Effects Cognition Disorders Risk Factors Lead Blood Cognition Evaluation Risk Assessment Child Health Adolescent Health Human Prospective Studies Cross Sectional Studies Multicenter Studies Child Adolescence Severity of Illness Intelligence Tests Executive Function Evaluation Attention Evaluation Child Behavior Evaluation Multiple Linear Regression Glomerular Filtration Rate Evaluation Scales Cognition Disorders Diagnosis Child: 6-12 years Adolescent: 13-18 years ab: Background: Environmental lead exposure is associated with cognitive impairment in healthy children, with deficits seen in intelligence quotient (IQ), attention, and behavior. Neurocognitive dysfunction is also a well-described complication among children with chronic kidney disease (CKD). The objective was to evaluate the association between blood lead levels (BLL) and performance on neurocognitive assessments in a cohort of children with CKD. Methods: Cross-sectional study of children with mild to moderate CKD from the Chronic Kidney Disease in Children (CKiD) multicenter prospective cohort study. The primary exposure was BLL. The primary outcome was performance on age-specific neurocognitive assessments evaluating IQ, executive functioning, attention, hyperactivity, and behavior. Multivariable linear regression was used to evaluate the association between BLL and neurocognitive performance, adjusted for key sociodemographic and clinical variables. Results: A total of 412 subjects were included with median age 15.4 years, median estimated GFR 39 mL/min/1.732, median BLL 1.2 mcg/dL, and median IQ score 99. In multivariable linear regression, higher BLL was associated with significantly lower IQ score (− 2.1 IQ points for every 1-mcg/dL increase in BLL, p = 0.029). Higher BLL was associated with worse scores on the Conners' Continuous Performance Test II Variability T-Score, a measure of inattention (+ 1.8 T-Score points for every 1-mcg/dL increase in BLL, p = 0.033). Conclusions: Low-level lead exposure is associated with significantly lower IQ and more inattention in children with CKD, a population already at high risk for neurocognitive dysfunction. Universal screening for elevated BLL should be considered for all children with CKD at age 12–24 months. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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