TY - JOUR
T1 - Quality of life of children and adolescents with chronic kidney disease
T2 - a cross-sectional study
AU - Francis, Anna
AU - Didsbury, Madeleine S.
AU - van Zwieten, Anita
AU - Chen, Kerry
AU - James, Laura J.
AU - Kim, Siah
AU - Howard, Kirsten
AU - Williams, Gabrielle
AU - Bahat Treidel, Omri
AU - McTaggart, Steven
AU - Walker, Amanda
AU - Mackie, Fiona
AU - Kara, Tonya
AU - Nassar, Natasha
AU - Teixeira-Pinto, Armando T.
AU - Tong, Allison
AU - Johnson, David
AU - Craig, Jonathan C.
AU - Wong, Germaine
PY - 2019/2
Y1 - 2019/2
N2 - Objective: The aim was to compare quality of life (QoL) among children and adolescents with different stages of chronic kidney disease (CKD) and determine factors associated with changes in QoL. Design: Cross-sectional. Setting: The Kids with CKD study involved five of eight paediatric nephrology units in Australia and New Zealand. Patients: There were 375 children and adolescents (aged 6-18 years) with CKD, on dialysis or transplanted, recruited between 2013 and 2016. Main outcome measures: Overall and domain-specific QoL were measured using the Health Utilities Index 3 score, with a scale from '0.36 (worse than dead) to 1 (perfect health). QoL scores were compared between CKD stages using the Mann-Whitney U test. Factors associated with changes in QoL were assessed using multivariable linear and ordinal logistic regression. Results: QoL for those with CKD stages 1-2 (n=106, median 0.88, IQR 0.63-0.96) was higher than those on dialysis (n=43, median 0.67, IQR 0.39-0.91, p<0.001), and similar to those with kidney transplants (n=135, median 0.83, IQR 0.59-0.97, p=0.4) or CKD stages 3-5 (n=91, 0.85, IQR 0.60-0.98). Reductions were most frequent in the domains of cognition (50%), pain (42%) and emotion (40%). The risk factors associated with decrements in overall QoL were being on dialysis (decrement of 0.13, 95% CI 0.02 to 0.25, p=0.02), lower family income (decrement of 0.10, 95% CI 0.03 to 0.15, p=0.002) and short stature (decrement of 0.09, 95% CI 0.01 to 0.16, p=0.02). Conclusions: The overall QoL and domains such as pain and emotion are substantially worse in children on dialysis compared with earlier stage CKD and those with kidney transplants.
AB - Objective: The aim was to compare quality of life (QoL) among children and adolescents with different stages of chronic kidney disease (CKD) and determine factors associated with changes in QoL. Design: Cross-sectional. Setting: The Kids with CKD study involved five of eight paediatric nephrology units in Australia and New Zealand. Patients: There were 375 children and adolescents (aged 6-18 years) with CKD, on dialysis or transplanted, recruited between 2013 and 2016. Main outcome measures: Overall and domain-specific QoL were measured using the Health Utilities Index 3 score, with a scale from '0.36 (worse than dead) to 1 (perfect health). QoL scores were compared between CKD stages using the Mann-Whitney U test. Factors associated with changes in QoL were assessed using multivariable linear and ordinal logistic regression. Results: QoL for those with CKD stages 1-2 (n=106, median 0.88, IQR 0.63-0.96) was higher than those on dialysis (n=43, median 0.67, IQR 0.39-0.91, p<0.001), and similar to those with kidney transplants (n=135, median 0.83, IQR 0.59-0.97, p=0.4) or CKD stages 3-5 (n=91, 0.85, IQR 0.60-0.98). Reductions were most frequent in the domains of cognition (50%), pain (42%) and emotion (40%). The risk factors associated with decrements in overall QoL were being on dialysis (decrement of 0.13, 95% CI 0.02 to 0.25, p=0.02), lower family income (decrement of 0.10, 95% CI 0.03 to 0.15, p=0.002) and short stature (decrement of 0.09, 95% CI 0.01 to 0.16, p=0.02). Conclusions: The overall QoL and domains such as pain and emotion are substantially worse in children on dialysis compared with earlier stage CKD and those with kidney transplants.
KW - chronic kidney disease
KW - children
KW - adolescents
KW - quality of life
UR - http://www.scopus.com/inward/record.url?scp=85050244646&partnerID=8YFLogxK
UR - http://purl.org/au-research/grants/nhmrc/1115259
UR - http://purl.org/au-research/grants/nhmrc/1092957
U2 - 10.1136/archdischild-2018-314934
DO - 10.1136/archdischild-2018-314934
M3 - Article
SN - 0003-9888
VL - 104
SP - 134
EP - 140
JO - Archives of Disease in Childhood
JF - Archives of Disease in Childhood
IS - 2
ER -
