Environmental lead exposure is associated with neurocognitive dysfunction in children with chronic kidney disease.
Children
Chronic kidney disease
Heavy metals
Lead
Neurocognition
Journal
Pediatric nephrology (Berlin, Germany)
ISSN: 1432-198X
Titre abrégé: Pediatr Nephrol
Pays: Germany
ID NLM: 8708728
Informations de publication
Date de publication:
11 2019
11 2019
Historique:
received:
09
05
2019
accepted:
10
07
2019
revised:
02
07
2019
pubmed:
22
7
2019
medline:
25
8
2020
entrez:
22
7
2019
Statut:
ppublish
Résumé
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. 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. A total of 412 subjects were included with median age 15.4 years, median estimated GFR 39 mL/min/1.73 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.
Sections du résumé
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/1.73
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.
Identifiants
pubmed: 31327061
doi: 10.1007/s00467-019-04306-7
pii: 10.1007/s00467-019-04306-7
pmc: PMC6800774
mid: NIHMS1042925
doi:
Substances chimiques
Lead
2P299V784P
Types de publication
Journal Article
Multicenter Study
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
2371-2379Subventions
Organisme : NIDDK NIH HHS
ID : U01 DK066143
Pays : United States
Organisme : NIEHS NIH HHS
ID : K23 ES016514
Pays : United States
Organisme : NIDDK NIH HHS
ID : U01 DK066174
Pays : United States
Organisme : NIDDK NIH HHS
ID : U24 DK066116
Pays : United States
Organisme : NIDDK NIH HHS
ID : U24 DK082194
Pays : United States
Organisme : NIH HHS
ID : K23ES016541
Pays : United States
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