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Kidney Week

Abstract: SA-PO369

Health-Related Quality of Life for Pediatric Patients with ESKD: A Systematic Review and Meta-Analysis of the PedsQL™

Session Information

  • Pediatric Nephrology - III
    November 04, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Pediatric Nephrology

  • 1900 Pediatric Nephrology

Authors

  • Doshi, Kush, Cleveland Clinic Akron General, Akron, Ohio, United States
  • Raina, Rupesh, Cleveland Clinic Akron General, Akron, Ohio, United States
  • Ng, Kar Hui, National University of Singapore, Singapore, Singapore
  • Koch, Vera, Universidade de Sao Paulo, Sao Paulo, Brazil
  • Bhatt, Girish Chandra, All India Institute of Medical Science - Bhopal, Bhopal, Madhya Pradesh, India
  • Sethi, Sidharth Kumar, Medanta The Medicity, Gurgaon, Haryana, India
  • Ferris, Maria E., The University of North Carolina at Chapel Hill Division of General Pediatrics and Adolescent Medicine, Chapel Hill, North Carolina, United States
Background

Health-related quality of life (HRQoL) studies demonstrate the impact of end-stage kidney disease (ESKD) on children's physical and psychosocial development. While several instruments measure HRQoL, few have standardized domains specific to pediatric ESKD. This review examines the published literature on the HRQoL among children with ESKD across differing renal replacement therapy (RRT) modalities, providing insight into the holistic care for these patients.

Methods

We conducted a literature review on pediatric HRQoL using the PedsQL™ 4.0 Generic Core Scale and the PedsQL™ 3.0 ESKD Module among 5 to 18-year-old patients. We queried PubMed, Embase, Web of Science, CINAHL, and Cochrane databases. Retrospective, case-controlled, and cross-sectional studies encompassing self/parent-reported PedsQL™ dimensional and total HRQoL scores were collected.

Results

Of 435 identified studies, 14 met the inclusion criteria. Meta-analysis demonstrated a significantly higher total HRQoL for healthy patients over those with ESKD [SMD: 1.44 (95% CI: 0.78 - 2.09); p<0.001] and across all dimensional scores. In addition, kidney transplant patients report a significantly higher total HRQoL than those on dialysis [PedsQL™ GCS, SMD: 0.33 (95% CI:0.14 - 0.53); p<0.001] and [PedsQL™ ESKD, SMD: 0.65 (95% CI: 0.39 - 0.90); p<0.001]. Kidney transplant patients also reported greater physical health scores than those on dialysis in self and parent/proxy reports of the PedsQL™ GCS [SMD: 0.51 (95% CI: 0.32 – 0.69); p<0.001] and [SMD: 0.30 (95% CI: 0.01 – 0.59); p=0.041], respectively.

Conclusion

Patients with ESKD report lower HRQoL in physical and psychosocial domains when compared to healthy controls. Pediatric transplant recipients showed better total HRQoL than dialysis patients, regardless of the specific modality, as observed on both PedsQL™ scales. This analysis demonstrates the need to identify areas of impaired functioning and produce congruent clinical recommendations.