OBJECTIVE: To compare the health-related quality of life (HRQoL) of children with chronic kidney disease (CKD) with healthy children; to evaluate the association between CKD severity and HRQoL; and to identity demographic, socioeconomic, and health-status variables that are associated with impairment in HRQoL in children with mild to moderate CKD.METHODS: This was a cross-sectional assessment of HRQoL in children who were aged 2 to 16 and had mild to moderate CKD using the Pediatric Inventory of Quality of Life Core Scales (PedsQL). Overall HRQoL and PedsQL domain means for parents and youth were compared with previously published norms by using independent sample t tests. Study participants were categorized by kidney disease stage (measured by iohexol-based glomerular filtration rate [iGFR]), and group differences in HRQoL were evaluated by using analysis of variance and Cuzick trend tests. The association between hypothesized predictors of HRQoL and PedsQL scores was evaluated with linear and logistic regression analyses.RESULTS: The study sample comprised 402 participants (mean age: 11 years, 60% male, 70% white, median iGFR: 42.5 mL/min per 1.73 m2, median CKD duration: 7 years). Youth with CKD had significantly lower physical, school, emotional, and social domain scores than healthy youth. iGFR was not associated with HRQoL. Longer disease duration and older age were associated with higher PedsQL scores in the domains of physical, emotional, and social functioning. Older age was associated with lower school domain scores. Maternal education ≥16 years was associated with higher PedsQL scores in the domains of physical, school, and social functioning. Short stature was associated with lower scores in the physical functioning domain.CONCLUSIONS: Children with mild to moderate CKD, in comparison with healthy children, reported poorer overall HRQoL and poorer physical, school, emotional, and social functioning. Early intervention to improve linear growth and to address school functioning difficulties is recommended.
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机译：目的：比较慢性肾脏病（CKD）儿童与健康儿童的健康相关生活质量（HRQoL）;评估CKD严重程度与HRQoL之间的关系;并确定与轻至中度CKD儿童HRQoL受损有关的人口统计学，社会经济和健康状况变量。方法：这是对2至16岁，轻度至中度CKD儿童的HRQoL的横断面评估。使用儿童生活质量核心量表（PedsQL）进行中度CKD。通过使用独立的样本t检验，将父母和青少年的总体HRQoL和PedsQL域均值与先前发布的规范进行了比较。将研究参与者按肾脏疾病阶段分类（通过基于碘海醇的肾小球滤过率[iGFR]进行测量），并使用方差分析和Cuzick趋势检验评估HRQoL的组差异。通过线性和逻辑回归分析评估假设的HRQoL预测因子与PedsQL得分之间的关联。结果：该研究样本包括402名参与者（平均年龄：11岁，男性占60％，白人占70％，iGFR中位数：每分钟42.5 mL / min 1.73平方米，中位数CKD持续时间：7年）。患有CKD的青年人的身体，学校，情感和社交领域得分均明显低于健康青年。 iGFR与HRQoL不相关。在身体，情感和社交功能方面，更长的疾病持续时间和更高的年龄与更高的PedsQL得分相关。年龄较大与较低的学校领域分数相关。 ≥16岁的孕产妇在身体，学校和社会功能领域中的PedsQL得分较高。结论：身材矮小与身体功能领域得分较低有关。结论：与健康儿童相比，轻度至中度CKD儿童的总体HRQoL较差，身体，学校，情感和社交功能较差。建议尽早干预以改善线性增长并解决学校的运作困难。
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