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Background <p>Chronic kidney disease (CKD) is associated with poorer neurocognitive outcomes. Neuroimaging studies have been mostly undertaken in older adults. However, individuals under 25 are uniquely impacted due to concurrent brain development.</p> Aims <p>This systematic review explored neuroimaging in children and young adults with CKD aiming to characterize brain outcomes in paediatric CKD.</p> Methods <p>A systematic search of MEDLINE Ovid, EMBASE and Cochrane databases was undertaken on October 10, 2024. Observational studies involving patients with CKD aged 0–25&#xa0;years and having neuroimaging findings as a key outcome were included. Following quality assessment using the Newcastle–Ottawa scale, a narrative review was performed. </p> Results <p>Sixteen studies were included: 737 individuals across studies. Smaller brain volumes were reported in three of five studies (with one contradictory). White matter integrity was impaired, even in patients with mild disease. The latter was associated with a lower intelligence quotient. Silent brain infarcts were identified in up to 79% of dialysis patients with associations with markers of bone disease, longer dialysis duration and haemodynamic instability. Brain regions involved in attention, executive functions and the resting-state network demonstrated abnormal connectivity that was associated with longer reactivity and a response time in visual memory task.&#xa0;Measures of anaemia were inversely associated with increased cerebral blood flow (CBF) which corresponded with poorer verbal memory.</p> Conclusion <p>Neurodevelopment is altered in paediatric CKD. Although a global mechanism for this remains unclear, it is evident that even early CKD is associated with increased risk of brain damage and cognitive deficits. Treatment methods and duration, disease severity and blood calcium and parathyroid concentrations were strongly associated with brain injury. Future work should prioritize longitudinal models of assessment with a focus on recruitment of uniform groups based on age, disease severity, aetiology and treatment to more clearly delineate the effects of disease on neurodevelopment.</p> Graphical Abstract <p></p>

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Systematic review of neuroimaging findings in children and young adults with chronic kidney disease

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月11日

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  • Promesse Kayumba,
  • Ryan Ward,
  • Rodney D. Gilbert,
  • Lyndsay Harshman,
  • Matthew Harmer

摘要

Background

Chronic kidney disease (CKD) is associated with poorer neurocognitive outcomes. Neuroimaging studies have been mostly undertaken in older adults. However, individuals under 25 are uniquely impacted due to concurrent brain development.

Aims

This systematic review explored neuroimaging in children and young adults with CKD aiming to characterize brain outcomes in paediatric CKD.

Methods

A systematic search of MEDLINE Ovid, EMBASE and Cochrane databases was undertaken on October 10, 2024. Observational studies involving patients with CKD aged 0–25 years and having neuroimaging findings as a key outcome were included. Following quality assessment using the Newcastle–Ottawa scale, a narrative review was performed.

Results

Sixteen studies were included: 737 individuals across studies. Smaller brain volumes were reported in three of five studies (with one contradictory). White matter integrity was impaired, even in patients with mild disease. The latter was associated with a lower intelligence quotient. Silent brain infarcts were identified in up to 79% of dialysis patients with associations with markers of bone disease, longer dialysis duration and haemodynamic instability. Brain regions involved in attention, executive functions and the resting-state network demonstrated abnormal connectivity that was associated with longer reactivity and a response time in visual memory task. Measures of anaemia were inversely associated with increased cerebral blood flow (CBF) which corresponded with poorer verbal memory.

Conclusion

Neurodevelopment is altered in paediatric CKD. Although a global mechanism for this remains unclear, it is evident that even early CKD is associated with increased risk of brain damage and cognitive deficits. Treatment methods and duration, disease severity and blood calcium and parathyroid concentrations were strongly associated with brain injury. Future work should prioritize longitudinal models of assessment with a focus on recruitment of uniform groups based on age, disease severity, aetiology and treatment to more clearly delineate the effects of disease on neurodevelopment.

Graphical Abstract