Abstract: SA-PO453

The Impact of CKD on Disability and Health-Related Quality of Life (HR-QOL) of Children and Adolescents

Session Information

Category: Chronic Kidney Disease (Non-Dialysis)

  • 306 CKD: Cognitive Dysfunction, Depression, Quality of Life

Authors

  • Francis, Anna, University of Sydney, Sydney, New South Wales, Australia
  • Mctaggart, Steven, Children's Health Queensland, Brisbane, Queensland, Australia
  • Johnson, David W., Princess Alexandra Hospital, Brisbane, Queensland, Australia
  • Craig, Jonathan C., University of Sydney/Children's Hospital, Sydney, New South Wales, Australia
  • Howard, Kirsten, University of Sydney, Sydney, New South Wales, Australia
  • Wong, Germaine, None, Auambie, New South Wales, Australia
  • Didsbury, Madeleine, Centre for Kidney Research, Westmead, New South Wales, Australia
  • Van zwieten, Anita, University of Sydney, Sydney, New South Wales, Australia
  • Chen, Kerry, The University of Sydney, Westmead, New South Wales, Australia
  • James, Laura J, The University of Sydney, Westmead, New South Wales, Australia
  • Kim, Siah, Sydney Children's Hospital, Newtown, New South Wales, Australia
  • Kara, Tonya, Starship Children's Hosptial, Auckland, New Zealand
  • Nassar, Natasha, University of Sydney, Sydney, New South Wales, Australia
  • Tong, Allison, The University of Sydney, Westmead, New South Wales, Australia
Background

Children with CKD suffer from reduced HR-QOL. The extent of impairment and risk factors for poorer HR-QOL and disability are under-studied. The study aimed to compare overall HR-QOL and severity of disability in children and adolescents with different stages of CKD and to determine factors associated with lower HR-QOL scores.

Methods

HR-QOL data were collected from children and adolescents (age 6-18 years) across five paediatric units in Australia and New Zealand. The Health Utilities Index 3 survey was used to measure overall utility based HR-QOL (where 0 represents being dead and 1 represents full health). A score of 1.00 represents no disability, 0.89-0.99 represents mild disability, 0.70-0.88 represents moderate disability and less than 0.70 represents severe disability. HR-QOL scores and disability stages were compared between CKD stages using the Mann-Whitney-U test. Multivariable linear regression assessed factors associated with decline in HR-QOL.

Results

There were 377 children with CKD (median age 12.6 years). The median unadjusted HR-QOL score for those with CKD stages 1-4 was 0.88 (interquartile range [IQR] 0.61-0.97), higher than those on dialysis (0.67, IQR 0.39-0.91, p<0.001), but similar to kidney transplant recipients (0.83, IQR 0.59-0.97, p=0.4). Severe disability was more common in dialysis patients (20/35, 57%), compared to transplant recipients (37/114, 33%) or those with CKD stages 1-4 (57/176, 32%) (c2=8.4, p=0.02) (table 1). The factors associated with decrements in HR-QOL were being on dialysis (compared to CKD stages 1-4: reduction by 0.13, 95%CI 0.02-0.24) and lowest quartile family income (compared to highest income quartile: reduction by 0.10, 95%CI 0.01-0.20), when adjusted for age and gender.

Conclusion

HR-QOL children with CKD was significantly related to stage of disease and family income, with children on dialysis and those the lowest family income having significant lower HR QOL.

Disability in children with CKD
 None to mild
disability
Moderate disabilitySevere
disability
Whole CKD cohort (n, %)138 (43)73 (22)114 (35)
Dialysis (n, %)10 (29)5 (14)20 (57)
Transplant (n, %)46 (40)31 (27)37 (33)
CKD 1-4 (n, %)82 (47)37 (21)57 (32)

Funding

  • Private Foundation Support