Neurological Complications and Associated Risk Factors in Children Affected with Chronic Kidney Disease

Abstract

To investigate the correlation between chronic kidney disease (CKD) and the development of neurological disease among pediatric patients in Saudi Arabia. The present retrospective study recruited patients admitted to King Abdulaziz University Hospital during 2018. We reviewed electronic records to collect data on essential demographics including age, gender, and nationality; history of prior CNS disease or related symptoms; results of neurological physical examination; and findings of radiological investigations such as abdominal ultrasound, dimercaptosuccinic acid scan, micturating cystourethrogram, diethylene triamine pentaacetic acid scan, brain computed tomography, and magnetic resonance imaging. The most commonly diagnosed renal pathologies were neurogenic bladder and cystic kidney disease. The most common neurological manifestation was seizure disorder. Males were more frequently affected with neurological sequelae than females. The prevalence of neurological disorders was higher in patients over two years old. The most frequently observed stage of chronic kidney disease was stage 5. Most children who were affected with a neurological disorder required hemodialysis as part of their management plan. Patients with chronic kidney disease are at a high risk of neurocognitive defects. The type of management and renal diagnosis are significant factors that should be considered when anticipating central nervous system involvement in the case of chronic kidney disease.

Risk Factors and Complications of Chronic Kidney Disease: Narrative Review

“…Uremic encephalopathy may appear when GFR decreases to 10% of the normal value and typically leads to mental fatigue, confusion, impaired consciousness, lethargy, difficulty concentrating, and myoclonic twitching of distal muscle groups, preterminally, coma [38,39]. The severity of uremic encephalopathy correlates with the extent and kinetics of the accumulation of uremic toxins, and studies have shown that many of the abnormalities found in uremic encephalopathy and calcium-induced brain abnormalities are due to kidney failure [40]. Other common abnormalities are the syndrome of neurologic dysfunction, which appears in the last part of hemodialysis or shortly afterward when uremia is corrected rapidly.…”