Systematic review of neuroimaging findings in children and young adults with chronic kidney disease
Bibliographic record
Abstract
BACKGROUND: Chronic kidney disease (CKD) is associated with poorer neurocognitive outcomes. Neuroimaging studies have been mostly undertaken in older adults. However, individuals under 25 are uniquely impacted due to concurrent brain development. AIMS: This systematic review explored neuroimaging in children and young adults with CKD aiming to characterize brain outcomes in paediatric CKD. METHODS: A systematic search of MEDLINE Ovid, EMBASE and Cochrane databases was undertaken on October 10, 2024. Observational studies involving patients with CKD aged 0-25 years and having neuroimaging findings as a key outcome were included. Following quality assessment using the Newcastle-Ottawa scale, a narrative review was performed. RESULTS: Sixteen studies were included: 737 individuals across studies. Smaller brain volumes were reported in three of five studies (with one contradictory). White matter integrity was impaired, even in patients with mild disease. The latter was associated with a lower intelligence quotient. Silent brain infarcts were identified in up to 79% of dialysis patients with associations with markers of bone disease, longer dialysis duration and haemodynamic instability. Brain regions involved in attention, executive functions and the resting-state network demonstrated abnormal connectivity that was associated with longer reactivity and a response time in visual memory task. Measures of anaemia were inversely associated with increased cerebral blood flow (CBF) which corresponded with poorer verbal memory. CONCLUSION: Neurodevelopment is altered in paediatric CKD. Although a global mechanism for this remains unclear, it is evident that even early CKD is associated with increased risk of brain damage and cognitive deficits. Treatment methods and duration, disease severity and blood calcium and parathyroid concentrations were strongly associated with brain injury. Future work should prioritize longitudinal models of assessment with a focus on recruitment of uniform groups based on age, disease severity, aetiology and treatment to more clearly delineate the effects of disease on neurodevelopment.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.030 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.008 | 0.005 |
| Bibliometrics | 0.012 | 0.012 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".