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Kidney Week

Abstract: PO2344

Treatment-Related Anxiety in Children After Kidney Transplant

Session Information

Category: Pediatric Nephrology

  • 1700 Pediatric Nephrology

Authors

  • Keyser, Michelle Nguyen, University of California San Diego, La Jolla, California, United States
  • Ingulli, Elizabeth G., Rady Children's Hospital, UC San Diego, San Diego, California, United States
  • Lee, Euyhyun, University of California San Diego, La Jolla, California, United States
  • Riviere, Paul, University of California San Diego, La Jolla, California, United States
Background

An increasing number of children experience anxiety and pediatric kidney transplant recipients are particularly susceptible to mental health conditions given the impact of their complex chronic medical histories on their quality of life. We performed a retrospective study to assess the impact of anxiety on health-related quality of life (HRQoL) in pediatric kidney transplant recipients in order to design targeted interventions to improve HRQoL after transplant.

Methods

We retrospectively analyzed scores from the disease-specific PedsQL 3.0 ESRD and Transplant Modules in pediatric ESRD and transplant patients ages 2-18 years between 2014 and 2019 at Rady Children’s Hospital. We used a linear mixed-effects model with a random intercept and ANOVA with Tukey post-hoc tests to analyze the effect of variables of interest on HRQOL in various groups.

Results

180 modules were completed by pediatric patients who received dialysis and/or kidney transplantation. Transplant recipients had significantly better total HRQOL scores compared to dialysis patients (p < 0.001). Treatment-related Anxiety was the lowest (worst) scoring domain among kidney transplant patients (p < 0.01), especially among patients ages 5-7 years old (p = 0.009). Patients 13-18 years old had the lowest scores in the Transplant domain, which measures social isolation related to a patient’s transplant (p = 0.008). Variables such as age at diagnosis, time on dialysis, diagnosis category, and time to transplant were not significant predictors of HRQoL.

Conclusion

These data suggest that children with kidney transplants have better HRQoL compared to children on dialysis. However, transplant recipients experience high rates of anxiety and social isolation. This may simply reflect the psychosocial stress surrounding medical care, but we may also be capturing more nuanced psychological issues in this population that requires further evaluation. Since transplant patients typically have frequent access to medical care, we have established a multi-disciplinary model in our clinic in part based on these data that utilizes psychologists to address acute and chronic psychological concerns simultaneous with their medical visits. This model may improve the HRQoL of transplant patients without increasing the overall burden of medical care and may have broader applicability to the general population of children with anxiety.