title: Health-related quality of life of children and adolescents with CKD stages 4-5 and their caregivers.
abstract: BACKGROUND
  Renal replacement therapies may affect the quality of life of patients and their primary caregivers (PC).
  
  
  METHODS
  This study describes the perception of health-related quality of life (HRQoL) of children/adolescents with CKD stages 4-5, as well as of their PC (n = 64), in comparison to healthy peers and their PC (n = 129), respectively, based on the Peds QL™ 4.0 and Short Form-36 (SF-36) questionnaires and selected biomarkers.
  
  
  RESULTS
  Patients reported a deleterious impact on physical capacity and on social and school activities. A negative influence on emotional aspects was reported by older patients, but not by their PC. Hemodialysis, followed by peritoneal dialysis, had a more negative impact on patients' physical functioning domain. PC HRQol proxy reports differed from those of their children, especially in older patients. PC of both groups presented similar SF-36 scores. An association was demonstrated between the magnitude of treatment target inadequacies, lower specific dominion scores in the patients/PC proxy reports and PC SF-36 general health scores.
  
  
  CONCLUSIONS
  The HRQoL of patients with CKD stages 4-5 is negatively affected to different degrees depending on age and treatment modality. The results suggest an association between worsening HRQoL parameters and inadequate control of recognized therapeutic CKD treatment targets.
authors.affiliation: Department of Pediatrics, Pediatric Nephrology Unit, Instituto da Criança Hospital das Clinicas of the University of Sao Paulo Medical School, Rua das Mangabeiras 91/81, 01233-010, São Paulo, Brazil.
authors.forename: Marcos
authors.initials: M
authors.lastname: Lopes
authors.forename: Alexandre
authors.initials: A
authors.lastname: Ferraro
authors.forename: Vera H
authors.initials: VH
authors.lastname: Koch
mesh_terms: D000293:Adolescent; D017028:Caregivers / Q000523:psychology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D010530:Peritoneal Dialysis / Q000523:psychology; D011788:Quality of Life; D006435:Renal Dialysis / Q000523:psychology; D051436:Renal Insufficiency, Chronic / Q000523:psychology* / Q000628:therapy