# Cognitive Profiles and Neuroimaging Correlates in Mild to Moderate Pediatric Chronic Kidney Disease

> **NIH NIH K23** · UNIVERSITY OF IOWA · 2020 · $160,501

## Abstract

Project Summary/Abstract
The purpose of this Mentored Patient-Oriented Research Career Development Award (K23) application is to
support my short-term career objective of quantitatively characterizing brain structure and function in children
with mild to moderate chronic kidney disease (CKD) using magnetic resonance imaging (MRI). Over 50% of all
cases of pediatric CKD are due to congenital (structural) anomalies, and as such, the diagnosis portends a life-
long diagnosis requiring routine care. Features of renal decline in pediatric CKD include metabolic acidosis,
cardiovascular disease, poor growth, and anemia—all of which may have a deleterious, multifactorial impact
on the developing brain. It is a natural extension that children with advanced CKD are at risk for neurocognitive
decline. Specifically, despite generally intact intelligence (IQ), children with CKD demonstrate deficits in
executive function and academic achievement. Neuroimaging research has utilized heterogenous samples
(including end-stage renal disease) with reliance on computerized tomography. No published pediatric studies
have applied quantitative structural or functional neuroimaging techniques. We will quantify structural and white
matter brain differences using MRI in pediatric CKD patients with mild to moderate, non-glomerular CKD
compared to healthy controls; it will be the first study to utilize functional MRI sequences to characterize brain
pH as a proxy of CKD-related metabolic disease. The study will use neurocognitive and laboratory assessment
in conjunction with neuroimaging correlates of brain structure and function in the pediatric CKD population. Our
hypotheses, based on preliminary data, predict volumetric and white matter differences will be observed in the
cerebellums of CKD participants. These differences will involve integral cortico-thalamic-cerebellar white
matter tracts associated with executive function. We will investigate a “dosage” effect of disease burden on
cerebellar volume and white matter development by evaluating a cross-sectional cohort of children with mild to
moderate CKD in comparison to healthy controls. Understanding the influence of pediatric CKD
progression and severity on the developing brain will allow enhanced awareness of the role of disease
progression, specifically metabolic disease, on neurodevelopmental outcomes in childhood and
inform new approaches to treatment and patient education across the CKD lifespan. My clinical work in
pediatric nephrology and introductory work with neuroimaging have laid a solid foundation for achieving these
goals. Further training is necessary in sophisticated neuroimaging methods, neurodevelopment, and statistics.
The proposed integrated research, mentorship, and didactic training programs, combined with the outstanding
research environment at the University of Iowa and off-site mentorship from faculty at Children's Hospital of
Philadelphia, will foster my long-term career objective to be an inde...

## Key facts

- **NIH application ID:** 9937793
- **Project number:** 5K23DK110443-05
- **Recipient organization:** UNIVERSITY OF IOWA
- **Principal Investigator:** Lyndsay Anne Harshman
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $160,501
- **Award type:** 5
- **Project period:** 2016-09-01 → 2021-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9937793

## Citation

> US National Institutes of Health, RePORTER application 9937793, Cognitive Profiles and Neuroimaging Correlates in Mild to Moderate Pediatric Chronic Kidney Disease (5K23DK110443-05). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/9937793. Licensed CC0.

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