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NDT Advance Access first published online on April 12, 2006
This version published online on April 21, 2006
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfl091
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© The Author [2006]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org
Received December 12, 2005
Accepted February 2, 2006

Original Article

Quality of life in children with chronic kidney disease--patient and caregiver assessments

Ann Marie McKenna 1, Laura E. Keating 1, Annette Vigneux 1, Sarah Stevens 1, Angela Williams 1, and Denis F. Geary 1 *

1 Division of Nephrology, Hospital for Sick Children, University of Toronto, Toronto, Canada

* To whom correspondence should be addressed.
Denis F. Geary, E-mail: denis.geary{at}sickkids.ca



  Abstract

Background. Children with chronic kidney disease (CKD) require strict dietary and lifestyle modifications, however, there is little information on their quality of life. Our objective was to compare health-related quality of life (HRQOL) in children with different stages of CKD to each other and to a control population.

Methods. A cross-sectional assessment of HRQOL for physical, emotional, social and school domains was performed using the PedsQLTM Generic Core Scale. Data were collected from 20 children with chronic renal insufficiency (CRI; creatinine >200 µmol/l), 12 on maintenance haemodialysis or peritoneal dialysis (DIAL) and 27 with renal transplants (TX). Caregiver proxy reports were obtained for CRI (n = 20), DIAL (n = 17) and TX (n = 21). Between-group differences were assessed with ANOVA for the CKD groups; t-tests compared our CKD samples with controls.

Results. Children with CKD scored lower than the controls in all subscales, however, only TX compared with controls was significant (P<0.02). DIAL children scored equal to or higher than the TX group in all domains. Analysis of covariance with number of medications as covariate yielded a significant result for the physical subscale (F = 8.95, df = 3, 53, P = 0.004). Proxy caregiver scores were lower than patient scores in all four domains.

Conclusions. Children with CKD rate their HRQOL lower than the healthy controls do. It may be reassuring to caregivers that children on dialysis rate their HRQOL higher than would be expected. However, it is of some concern that caregiver perception of improved HRQOL following transplantation was not shared by their children in the present study.

Keywords: chronic renal disease; dialysis; health-related quality of life; paediatric; renal transplant.
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