Early Pediatric Chronic Kidney Disease is Associated with Brain Volumetric Gray Matter Abnormalities

BACKGROUND: The impact of pediatric chronic kidney disease (pCKD) on the brain remains poorly defined. The objective of this study was to compare brain morphometry between children with early stage pCKD and typically developing peers using structural magnetic resonance imaging (MRI). METHODS: The sample age range was 6–16 years. A total of 18 children with a diagnosis of pCKD (CKD stages 1–3) due to congenital anomalies of the kidney and urinary tract and 24 typically developing peers were included. Volumetric data from MRI and neurocognitive testing were compared using linear models including pCKD status, age, maternal education level, and socioeconomic status. RESULTS: Cerebellar gray matter volume was significantly smaller in pCKD, t((38))=−2.71, p = 0.01. In contrast, cerebral gray matter volume was increased in pCKD, t((38))=2.08, p = 0.04. Reduced cerebellum gray matter volume was associated with disease severity, operationalized as estimated glomerular filtration rate (eGFR), t((14))=2.21, p = 0.04 and predicted lower verbal fluency scores in the pCKD sample. Enlarged cerebral gray matter in the pCKD sample predicted lower scores on mathematics assessment. CONCLUSION: This study provides preliminary evidence for a morphometric underpinning to the cognitive deficits observed in pCKD.