Structural brain abnormalities in children and young adults with severe chronic kidney disease

Sophie Lijdsman*, Marsh Königs, Marit S. van Sandwijk, Antonia H. Bouts, Koen van Hoeck, Huib de Jong, Marc Engelen, Jaap Oosterlaan, Frederike J. Bemelman, Kim J. Oostrom, Jaap W. Groothoff

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

6 Citations (Scopus)
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Background: The pathophysiology of neurological dysfunction in severe chronic kidney disease (CKD) in children and young adults is largely unknown. We aimed to investigate brain volumes and white matter integrity in this population and explore brain structure under different treatment modalities. Methods: This cross-sectional study includes 24 patients with severe CKD (eGFR < 30) aged 8–30 years (median = 18.5, range = 9.1–30.5) on different therapy modalities (pre-dialysis, n = 7; dialysis, n = 7; transplanted, n = 10) and 21 healthy controls matched for age, sex, and parental educational level. Neuroimaging targeted brain volume using volumetric analysis on T1 scans and white matter integrity with tract-based spatial statistics and voxel-wise regression on diffusion tensor imaging (DTI) data. Results: CKD patients had lower white matter integrity in a widespread cluster of primarily distal white matter tracts compared to healthy controls. Furthermore, CKD patients had smaller volume of the nucleus accumbens relative to healthy controls, while no evidence was found for abnormal volumes of gray and white matter or other subcortical structures. Longer time since successful transplantation was related to lower white matter integrity. Exploratory analyses comparing treatment subgroups suggest lower white matter integrity and smaller volume of the nucleus accumbens in dialysis and transplanted patients relative to healthy controls. Conclusions: Young CKD patients seem at risk for widespread disruption of white matter integrity and to some extent smaller subcortical volume (i.e., nucleus accumbens). Especially patients on dialysis therapy and patients who received a kidney transplant may be at risk for disruption of white matter integrity and smaller volume of the nucleus accumbens. Graphical abstract: [Figure not available: see fulltext.]

Original languageEnglish
Pages (from-to)1125-1136
Number of pages12
JournalPediatric Nephrology
Issue number5
Publication statusPublished - May 2022

Bibliographical note

Funding Information:
This study was partly funded by the Dutch Kidney Foundation.

Publisher Copyright: © 2021, The Author(s).


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