Desempenho cognitivo e sintomas de depressão e ansiedade em crianças e adolescentes com doença renal crônica pré-dialítica

Abstract

Few studies have investigated cognitive impairment and psychiatric morbidity in pediatric population, mostly considering patients with chronic diseases. Therefore, the aim of this study was to investigate the presence of cognitive impairment and symptoms of depression and anxiety in children and adolescents with CKD. Methods: Twenty-six pre-dialysis CKD patients, between 8 and 17 years, from the multidisciplinary outpatient clinic of the Pediatric Nephrology Unit (Hospital das Clínicas, Federal University of Minas Gerais) and 52 healthy volunteers, sex- and age-matched, recruited from public schools of Belo Horizonte were included. Cognitive assessment evaluated the intelligence quotient (IQ), attention, memory, executive functions, cognitive flexibility, inhibitory control and planning. Symptoms of depression and anxiety were also evaluated. Results: CKD patients and controls differed significantly in IQ values (85.9 ± 16.8 versus 106.9 ± 14.5, p 0.01). The total number of attempts in the Tower of London task was significantly higher in DRC patients (p < 0.001) and the patients were significantly slower in the Stroop test (p< 0.01), as well in the Trail Making Test (p <0.05). The stage of CKD did not influence performance in cognitive assessment. CKD patients had higher scores on STAI-C1, "state anxiety" (p<0.01). Despite the absence of statistical significance, a greater tendency to depressive symptoms was also seen in CKD patients. Conclusion: Children and adolescents with CKD exhibited worse cognitive performance than controls, with deficits in intelligence and executive functions. In addition, compared to controls, anxiety symptoms were significantly more frequent in CKD patients.