The brain in pediatric chronic kidney disease-the intersection of cognition, neuroimaging, and clinical biomarkers.
The brain in pediatric chronic kidney disease-the intersection of cognition, neuroimaging, and clinical biomarkers.
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DOI：
10.1007/s00467-019-04417-1
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发表时间：
2020-12
期刊：
影响因子：
--
通讯作者：
Hooper SR
中科院分区：
文献类型：
--
作者：
Harshman LA;Hooper SR
大脑生长和发育在儿童早期到青春期达到高峰，对于一些儿童来说，这必须与慢性肾脏疾病（CKD），相关的医疗条件及其治疗一起发生。本文综述了迄今为止关于儿童CKD大脑的主要研究结果。在这里，我们特别讨论了儿童CKD的神经影像学和认知问题，并考虑了可能影响认知的疾病进展生物标志物。目前的认知数据表明，大多数患有轻度至中度CKD的儿童并没有表现出明显的认知障碍;相反，存在一定程度的智力低下和选定执行功能的细微缺陷。虽然有希望，但现代神经影像学数据在儿童CKD人群中将认知结果与神经影像学相关性联系起来仍无定论。当然，重要的是要注意，即使是微妙的认知问题，如果没有得到适当的认识或解决，也会对学习、社会功能和整体生活质量造成障碍。进一步的纵向研究，利用同步和有针对性的认知和神经影像学评价是必要的，以更好地了解CKD进展对大脑发育和相关的神经认知结果的影响。
Brain growth and development occur at peak rates in early childhood through adolescence, and for some children this must happen in conjunction with chronic kidney disease (CKD), associated medical conditions, and their treatment(s). This review provides an overview of key findings to date on the topic of the brain in pediatric CKD. Here, we specifically address the topics of neuroimaging and cognition in pediatric CKD with consideration to biomarkers of disease progression that may impact cognition. Current cognitive data suggest that most children with mild to moderate CKD do not exhibit significant cognitive impairments; but, rather, the presence of somewhat lower intellectual abilities and subtle deficits in selected executive functions. Although promising, modern neuroimaging data remain inconclusive in linking cognitive findings to neuroimaging correlates in the pediatric CKD population. Certainly, it is important to note that even subtle cognitive concerns can present barriers to learning, social functioning, and overall quality of life if not appropriately recognized or addressed. Further longitudinal research utilizing concurrent and targeted cognitive and neuroimaging evaluations is warranted to better understand the impact of CKD progression on brain development and associated neurocognitive outcomes.
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DOI：
10.1053/j.ajkd.2017.11.024
发表时间：
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期刊：
American journal of kidney diseases : the official journal of the National Kidney Foundation
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