The purpose of the project is to establish the longitudinal effects of end stage renal disease (ESRD) on the neuropsychological and neurophysiological functions of children and adolescents. The institution of hemodialysis, continuous ambulatory peritoneal dialysis (CAPD), or kidney transplantation as modes of therapy for ESRD will be studied as to their specific effects on these various parameters. The changes noted in these tests may be utilized to assess the need for dialysis, the better mode of dialysis, and the adequacy of a specific dialysis protocol. Fifty children between the ages of 6 and 19 will be chosen from a population of children with ESRD receiving their medical care at the Children's Comprehensive Kidney Failure Center at the University of Florida. The children will be grouped as follows: 1) mild renal failure (creatinine clearance 25-50 cc/min/1.73M2); 2) moderate renal failure (creatinine clearance less than 25 cc/min/1.73M2 but not requiring dialysis); 3) severe renal failure receiving hemodialysis therapy; 4) several renal failure receiving CAPD therapy; and 5) following successful kidney transplantation (creatinine clearance greater than 50 cc/min/1.73M2). These patients will be given a battery of neuropsychological and neurophysiological tests repeated over a two year period. In addition, medical parameters such as dialysis schedules, ultrafiltration requirements, blood pressures, medications, renal function (creatinine clearance) and serum chemistries will be correlated with neuropsychological performance and function. A control group of 25-30 children with the same age distribution will be chosen from the Public School system and given the same battery of neuropsychological and neurophysiological tests. Statistical models will be established to longitudinally evaluate each treatment modality in terms of performance on these tests.
