title: Health-related quality of life of children with mild to moderate chronic kidney disease.
abstract: 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 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 > or =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.
authors.affiliation: Johns Hopkins University School of Medicine, Department of Pediatrics, Division of Pediatric Nephrology, 200 N Wolfe St, #3060, Baltimore, MD 21287, USA. agerson@jhmi.edu
authors.forename: Arlene C
authors.initials: AC
authors.lastname: Gerson
authors.forename: Alicia
authors.initials: A
authors.lastname: Wentz
authors.forename: Allison G
authors.initials: AG
authors.lastname: Abraham
authors.forename: Susan R
authors.initials: SR
authors.lastname: Mendley
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Hooper
authors.forename: Robert W
authors.initials: RW
authors.lastname: Butler
authors.forename: Debbie S
authors.initials: DS
authors.lastname: Gipson
authors.forename: Marc B
authors.initials: MB
authors.lastname: Lande
authors.forename: Shlomo
authors.initials: S
authors.lastname: Shinnar
authors.forename: Marva M
authors.initials: MM
authors.lastname: Moxey-Mims
authors.forename: Bradley A
authors.initials: BA
authors.lastname: Warady
authors.forename: Susan L
authors.initials: SL
authors.lastname: Furth
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D005260:Female; D005919:Glomerular Filtration Rate; D006304:Health Status; D006801:Humans; D007674:Kidney Diseases / Q000503:physiopathology; D008297:Male; D011788:Quality of Life; D012959:Socioeconomic Factors