Experiences and Needs of Families Caring for Children and Adolescents With Chronic Kidney Disease: A meta-Synthesis

ObjectiveThe aim was to compare quality of life (QoL) among children and adolescents with different stages of chronic kidney disease (CKD) and determine factors associated with changes in QoL.DesignCross-sectional.SettingThe Kids with CKD study involved five of eight paediatric nephrology units in Australia and New Zealand.PatientsThere were 375 children and adolescents (aged 6–18 years) with CKD, on dialysis or transplanted, recruited between 2013 and 2016.Main outcome measuresOverall and domain-specific QoL were measured using the Health Utilities Index 3 score, with a scale from −0.36 (worse than dead) to 1 (perfect health). QoL scores were compared between CKD stages using the Mann-Whitney U test. Factors associated with changes in QoL were assessed using multivariable linear and ordinal logistic regression.ResultsQoL for those with CKD stages 1–2 (n=106, median 0.88, IQR 0.63–0.96) was higher than those on dialysis (n=43, median 0.67, IQR 0.39–0.91, p<0.001), and similar to those with kidney transplants (n=135, median 0.83, IQR 0.59–0.97, p=0.4) or CKD stages 3–5 (n=91, 0.85, IQR 0.60–0.98). Reductions were most frequent in the domains of cognition (50%), pain (42%) and emotion (40%). The risk factors associated with decrements in overall QoL were being on dialysis (decrement of 0.13, 95% CI 0.02 to 0.25, p=0.02), lower family income (decrement of 0.10, 95% CI 0.03 to 0.15, p=0.002) and short stature (decrement of 0.09, 95% CI 0.01 to 0.16, p=0.02).ConclusionsThe overall QoL and domains such as pain and emotion are substantially worse in children on dialysis compared with earlier stage CKD and those with kidney transplants.

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Creatinine-based equation to estimate the glomerular filtration rate in Japanese children and adolescents with chronic kidney disease

Clinical and Experimental Nephrology ◽

10.1007/s10157-013-0856-y ◽

2013 ◽

Vol 18 (4) ◽

pp. 626-633 ◽

Cited By ~ 95

Author(s):

Osamu Uemura ◽

Takuhito Nagai ◽

Kenji Ishikura ◽

Shuichi Ito ◽

Hiroshi Hataya ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Glomerular Filtration Rate ◽

Kidney Disease ◽

Children And Adolescents ◽

Glomerular Filtration ◽

Filtration Rate ◽

Japanese Children

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Renal hypertension and cardiovascular disorder in children with chronic kidney disease

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh1402113p ◽

2014 ◽

Vol 142 (1-2) ◽

pp. 113-117 ◽

Cited By ~ 2

Author(s):

Amira Peco-Antic ◽

Dusan Paripovic

Keyword(s):

Blood Pressure ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Children And Adolescents ◽

Ambulatory Blood Pressure ◽

Pressure Measurement ◽

Blood Pressure Measurement ◽

Renal Hypertension ◽

Masked Hypertension ◽

Ambulatory Blood Pressure Measurement

Renal hypertension is one of the earliest and the most prevalent complications of pediatric chronic kidney disease (CKD). Among renal patients, hypertension is frequently underdiagnosed and undertreated. For casual blood pressure measurement, the best method is auscultatory, while for ambulatory blood pressure measurement, oscillometric method is the most commonly used. Both casual and ambulatory blood pressure measurement provide more powerful means of diagnosing hypertension. Masked hypertension is a condition in which casual blood pressure is normal but ambulatory blood pressure is elevated. The risk of cardiovascular morbidity and mortality is higher with masked hypertension as compared to the controls. Children and adolescents with CKD are at high risk of cardiovascular disease that has been established as the leading cause of death in patients with end stage renal disease. Left ventricular hypertrophy remains the most thoroughly documented form of end-organ damage caused by hypertension in children and adolescents with CKD. Based on clear evidence on the correlation between blood pressure and cardiovascular morbidity, mortality, and renal function, renal hypertension must be aggressively treated. Target blood pressure for patients with renal hypertension should be at low normal values: <75 percentile for patients without proteinuria and <50 percentile for patients with proteinuria. Renin-angiotensin system antagonists are considered the first choice pharmacological option in hypertensive CKD 2-4 patients while the management of volume overload is the most important in dialysis patients. Successful transplantation can eliminate or significantly improve uremia-related cardiovascular risk factors and increase predicted life expectancy.

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