BACKGROUND Clinicians often use information about developmental outcomes in decision-making around offering complex, life-saving interventions in children such as dialysis and renal transplant. This information in children with end-stage renal disease (ESRD) is limited, particularly when ESRD onset is in infancy or early childhood. METHODS Using data from an ongoing prospective, longitudinal, inception cohort study of children with renal transplant before 5 years of age, we evaluated (1) the risk of adverse neurocognitive and functional outcomes at 5 years of age and (2) predictors of developmental outcomes. RESULTS We found evidence of neurocognitive sequelae of ESRD in very young children; however, developmental outcomes appear remarkably better when compared with findings of two or three decades ago. Less time on dialysis predicted higher developmental scores, and hemodialysis was associated with poorer developmental outcomes. CONCLUSIONS Our data suggest that renal replacement therapies in young children are associated with acceptable developmental outcome. Programs to identify those with developmental delays and provide early intervention may allow achievement of the child's full potential.

中文翻译：

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儿童早期肾移植后5岁时的神经认知和功能结局。

背景技术临床医生经常在决策中使用有关发育结果的信息，围绕为儿童提供复杂的挽救生命的干预措施，例如透析和肾移植。患有终末期肾病（ESRD）的儿童的信息有限，尤其是当ESRD处于婴儿期或儿童早期时。方法使用一项正在进行的前瞻性，纵向，前期队列研究对5岁以下肾脏移植患儿进行研究的数据，我们评估（1）5岁时不良的神经认知和功能结局的风险，以及（2）发育结局的预测因子。结果我们发现了很小的孩子ESRD的神经认知后遗症的证据。然而，与两，三十年前的发现相比，发展成果似乎要好得多。较少的透析时间预示着较高的发育评分，而血液透析与较差的发育结果相关。结论我们的数据表明，幼儿肾脏替代疗法与可接受的发育结果有关。识别发育迟缓者并提供早期干预的计划可能使孩子发挥全部潜能。