ESPN 51th Annual Meeting

ESPN 2018


 
Sleep and executive function in children with Chronic Kidney Disease
STELLA STABOULI 1 DIMOS GIDARIS 1 NIKOLETA PRINTZA 1 JOHN DOTIS 1 ELENI PAPADIMITRIOU 1 KATERINA CHRYSAIDOU 1 FOTIOS PAPACHRISTOU 1

1- 1ST PEDIATRIC DEPARTMENT, HIPPOKRATION HOSPITAL, ARISTOTLE UNIVERSITY OF THESSALONIKI, GREECE
 
Introduction:

Sleep disorders and executive function in children with Chronic Kidney disease (CKD) have been scarcely studied. The aims of the present study were to assess measures of executive function in children with CKD, and to investigate possible correlations with sleep-related disorders.

Material and methods:

The study population included 51 children and adolescents with CKD stages 2-5, aged 5-18 years, and 51 controls with similar age and sex. Parents of both patients and controls completed two validated pediatric questionnaires, the Pediatric Sleep Questionnaire (PSQ), and the Behavior Rating Inventory of Executive Function (BRIEF) questionnaire. T scores and percentiles for BRIEF scales were used according to previously published normative values. Higher scores indicate greater degrees of dysfunction.

Results:

The CKD group presented statistically significant higher scores than the control group in sleep related breathing disorder (SRBD)(0.16±0.11 vs. 0.08±0.11, P <0.001), insomnia (0.18±0.26 vs. 0.08±0.13, P<0.05), and daytime sleepiness scales (0.16±0.25 vs. 0.02±0.09, P= 0.001). Children with CKD had also elevated T scores in Behavioral Regulation Index (BRI), Metacognition Index (MI) and Global Executive Composite (GEC) compared to controls (54.39±8.98 vs. 49.468±9.76, P<0.05, 51.47±8.80 vs. 46.82±8.39 P<0.05, 53.00±8.59 vs. 47.22±8.02, P<0.005, respectively). SRBD score correlated with all BRIEF scales T scores and percentiles, while insomnia score correlated only with MI scales T score and percentile. In multivariate analysis differences between CKD patients and controls for MI and GEC percentiles did not persist after adjustment for SRBD and Insomnia scores, but remained significant for BRI T scores and percentiles (BRI pc 66.06 vs. 49.09, P=0.007, BRI T score 53.48 vs. 48.58, P= 0.01).

Conclusions:

The results of the present study show a potential impairment of aspects of executive function in CKD pediatric patients. Sleep may significantly affect neurocognitive function performance in CKD patients with reagard to the ability of modulating emotions and behavior via appropriate inhibitory control, but additional factors may influence the ability to monitor his or her performance.