Journal
PEDIATRIC NEPHROLOGY
Volume 31, Issue 11, Pages 2137-2144Publisher
SPRINGER
DOI: 10.1007/s00467-016-3425-2
Keywords
Hypertension; Pediatric; Neuropsychological testing; Kidney; CKD
Categories
Funding
- NHLBI NIH HHS [R01 HL098332] Funding Source: Medline
- NICHD NIH HHS [U54 HD079123] Funding Source: Medline
- NIDDK NIH HHS [U01 DK066143, U01 DK066174, U01 DK066116, U01 DK082194] Funding Source: Medline
Ask authors/readers for more resources
Background Children with chronic kidney disease (CKD) and hypertension have increased blood pressure variability (BPV), which has been associated with lower neurocognitive test scores in adults. Children with CKD are at risk for decreased neurocognitive function. Our objective was to determine whether children with CKD and increased BPV had worse performance on neurocognitive testing compared with children with CKD and lower BPV. Methods This was a cross-sectional and longitudinal analysis of the relation between BPV and neurocognitive test performance in children >= 6 years enrolled in the Chronic Kidney Disease in Children (CKiD) study. Visit-to-visit BPV was assessed by the standard deviation of visit BPs (BPV-SD) and average real variability (ARV). Ambulatory BPV was assessed by SD of wake and sleep periods on 24-h ambulatory BP monitoring. Results We assessed 650 children with a mean follow-up period of 4.0 years. Children with systolic visit-to-visit BPV in the upper tertile had lower scores on Delis-Kaplan Executive Function System (D-KEFS) Verbal Category Switching than those with BPV in the lower tertile (BPV-SD, 8.3 vs. 9.5, p = 0.006; ARV, 8.5 vs. 9.6, p = 0.02). On multivariate analysis, the association between lower Category Switching score and increased BPV remained significant after controlling for mean BP, demographic characteristics, and disease-related variables [BPV-SD, beta = -0.7, 95 % confidence interval (CI) -1.28 to -0.12; ARV, beta = -0.54, CI -1.05 to -0.02). Ambulatory BPV was not independently associated with any cognitive measure. Conclusions Higher systolic visit-to-visit BPV was independently associated with decreased D-KEFS Category Switching scores in children with mild-to-moderate CKD.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available