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.