Assessing health status and health care utilization in adolescents with chronic kidney disease.
Few validated health status measures have been assessed in children with chronic kidney disease (CKD). The objective was to assess the validity of a generic health status measure, the Child Health and Illness Profile-Adolescent Edition (CHIP-AE), in adolescents with CKD. A case-control study was performed (1) to assess scores on the CHIP-AE in adolescents with CKD compared with two control groups of age-, socioeconomic-, and gender-matched peers and (2) to compare health of patients who had chronic renal insufficiency (CRI), were on dialysis, and were posttransplantation. Seven pediatric nephrology centers recruited 113 patients (mean age, 14 yr; 39 CRI, 21 dialysis, 53 posttransplantation). Compared with 226 control subjects, patients with CKD had lower overall satisfaction with health and more restriction in activity. Positively, patients with CKD had more family involvement, better home safety and health practices, and better social problem-solving skills and were less likely to participate in risky social behaviors or socialize with peers who engaged in risky behavior. Patients who received dialysis were less physically active and experienced more physical discomfort and limitations in activities than did transplant or CRI patients. It is concluded that patients with CKD have poorer functional health status than age-matched peers. Among CKD patients, dialysis patients have the poorest functional health status. These results suggest that the CHIP-AE can be used to measure functional health status in adolescent patients with CKD.
Gerson
Arlene C
AC
Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287-2535, USA.
Riley
Anne
A
Fivush
Barbara A
BA
Pham
Ngoc
N
Fiorenza
Jeffrey
J
Robertson
Judy
J
Chandra
Manju
M
Trachtman
Howard
H
Weiss
Robert
R
Furth
Susan L
SL
D000293:Adolescent; D002648:Child; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D007676:Kidney Failure, Chronic / Q000601:surgery / Q000628:therapy*; D016030:Kidney Transplantation / Q000706:statistics & numerical data*; D008297:Male; D006435:Renal Dialysis / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires / Q000592:standards