Kidney Week

Abstract: SA-OR020

Trajectories of HRQOL in Children with CKD

Session Information

• CKD: Health Services, Disparities, Prevention
  November 04, 2017 | Location: Room 282, Morial Convention Center
  Abstract Time: 06:18 PM - 06:30 PM

Category: Chronic Kidney Disease (Non-Dialysis)

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

Authors

• Gerson, Arlene C., Johns Hopkins School of Medicine, Baltimore, Maryland, United States

Arlene C. Gerson, PhD



• Matheson, Matthew, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States

Matthew Matheson,

• Johnson, Rebecca J., Children's Mercy Kansas City , Kansas City, Missouri, United States

Rebecca J. Johnson,

• Hooper, Stephen R., University of North Carolina School of Medicine, Chapel Hill, North Carolina, United States

Stephen R. Hooper,

• Shinnar, S., Montefiore Medical Center, Albert EInstein College of MEdicine, Bronx, New York, United States

S. Shinnar,

• Warady, Bradley A., The Children's Mercy Hospital, Kansas City, Missouri, United States

Bradley A. Warady,

• Furth, Susan L., The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States

Susan L. Furth,

• Wong, Cynthia, Stanford University , Stanford, California, United States

Cynthia Wong,

• Kogon, Amy, Nationwide Children's Hospital , Columbus, Ohio, United States

Amy Kogon,

• Lande, Marc, University of Rochester, Rochester, New York, United States

Marc Lande,

• Harshman, Lyndsay, University of Iowa Children's Hospital, Iowa City, Iowa, United States

Lyndsay Harshman,

• Mendley, Susan R., University of Maryland, Baltimore, Maryland, United States

Susan R. Mendley,

Background

Trajectories of health related quality of life (HRQOL) may offer valuable insights into psychosocial aspects of disease progression in children with chronic kidney disease (CKD). Few longitudinal studies have evaluated the impact of CKD duration on HRQOL. The aim of this study was to determine how HRQOL changes over the time course of CKD.

Methods

The subjects in this study were participants in the Chronic Kidney Disease in Children (CKiD) cohort who completed the Pediatric Quality of Life Inventory (PedsQL) on three or more occasions over the course of two or more years. Generalized gamma (GG) mixed effects models were applied to assess the effect of CKD duration on HRQOL while controlling for confirmed covariates from previous cross-sectional analyses.

Results

660 children (median age: 11.3) with a median of 8.5 years duration of CKD were evaluated. GG models with child self-report PedsQL data indicated that longer CKD duration was associated with improved Overall, Physical, Emotional, Social and School HRQOL. GG models with parent-proxy PedsQL data indicated that longer duration was associated with worse School HRQOL. Increasing trajectories of child self-report HRQOL were observed in the majority of subjects (ranging from 64% to 96% depending on subscale and baseline HRQOL level), while lower percentages of increasing trajectories were observed on parent-proxy scales. In the overall group there was no significant relationship between HRQOL and time varying GFR.

Conclusion

Longer duration of disease is associated with improved HRQOL on all child self-report scales. This finding may be a function of changes in internal standards, values or conceptualization of illness.

Table 1. Significance of CKD duration from generalized gamma mixed effects models and effects on PedsQL scores at the 25th percentile

Funding

• NIDDK Support