Health-Related Quality of Life of Children With Mild to Moderate Chronic Kidney Disease
Health-Related Quality of Life of Children With Mild to Moderate Chronic Kidney Disease
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DOI：
10.1542/peds.2009-0085
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发表时间：
2010-02-01
期刊：
影响因子：
8
通讯作者：
Furth, Susan L.
中科院分区：
文献类型：
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作者：
Gerson, Arlene C.;Wentz, Alicia;Furth, Susan L.
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 之间的关联；方法：这是使用儿科生活质量核心量表 (PedsQL) 对 2 至 16 岁轻度至中度 CKD 儿童的 HRQoL 进行横断面评估。通过使用独立样本 t 检验，将父母和青少年的总体 HRQoL 和 PedsQL 域平均值与之前发布的规范进行比较。研究参与者按肾脏疾病阶段进行分类（通过基于碘海醇的肾小球滤过率 [iGFR] 测量），并通过方差分析和 Cuzick 趋势检验评估 HRQoL 的组间差异。通过线性和逻辑回归分析来评估 HRQoL 和 PedsQL 评分的假设预测因子之间的关联。 结果：研究样本包括 402 名参与者（平均年龄：11 岁，60% 男性，70% 白人，中位 iGFR：42.5 mL/min 每 1.73 m(2)，中位 CKD 持续时间：7 年）。患有 CKD 的青少年的身体、学校、情感和社交领域得分显着低于健康青少年。 iGFR 与 HRQoL 无关。病程较长和年龄较大与身体、情感和社会功能领域的 PedsQL 得分较高相关。年龄较大与较低的学校领域分数相关。母亲受教育年限 >= 16 年与体育、学校和社会功能领域较高的 PedsQL 得分相关。身材矮小与身体功能领域得分较低相关。结论：与健康儿童相比，患有轻度至中度 CKD 的儿童的总体 HRQoL 较差，身体、学校、情感和社会功能较差。建议早期干预以改善线性生长并解决学校运作困难。儿科2010; 125:e349-e357
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 ttests. 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 m(2), 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. Pediatrics 2010; 125:e349-e357