Neurocognitive and Motor Performance in Pediatric Kidney Transplant Recipients: A Cross-Sectional Controlled Study.

Background/Objectives: Although kidney transplantation improves survival and quality of life in children with end-stage kidney disease, neurocognitive and motor impairments acquired during chronic kidney disease (CKD) may persist after transplantation. Cognitive-motor evaluations in this population remain limited. This study compared cognitive function, manual dexterity, grip strength, reaction time, and balance between pediatric kidney transplant recipients and healthy peers. Methods: This study included 30 pediatric kidney transplant recipients aged 8-18 years and 30 age- and sex-matched healthy controls. Cognitive function was assessed using the Stroop Color-Word Test. Fine and gross manual dexterity were evaluated using the Nine-Hole Peg Test and Box and Block Test, respectively. Handgrip strength was measured with a JAMAR dynamometer, reaction time with the FitLight Trainer™ system, and balance with the Pediatric Balance Scale. Results: Compared with healthy controls, pediatric kidney transplant recipients showed poorer executive function, demonstrated by longer Stroop completion times and more color-word errors (all p < 0.05). Manual dexterity was reduced, with a significantly lower Box and Block Test score for the dominant hand (p = 0.020) and longer Nine-Hole Peg Test completion times for both hands (both p < 0.001), whereas the between-group difference in the non-dominant Box and Block Test did not reach statistical significance (p = 0.055). Dominant-hand reaction time and reaction time during the cognitive task were significantly prolonged (p = 0.018 and p = 0.046, respectively). Handgrip strength and Pediatric Balance Scale scores did not differ significantly between groups (both p > 0.05). Conclusions: Pediatric kidney transplant recipients exhibit persistent impairments in executive function, manual dexterity, and cognitive-motor performance despite transplantation. Long-term follow-up should incorporate cognitive and motor assessments to support early rehabilitation and optimize functional outcomes.