Health and wealth in children and adolescents with chronic kidney disease (K-CAD study).
BACKGROUND
The impact of reduced kidney function in children is substantial. End-stage kidney disease (ESKD), the most severe form of chronic kidney disease (CKD), is a devastating illness associated with substantially increased mortality, impaired growth and psychosocial maladjustment in children. Understanding how to address the complex causes of mortality and morbidity in children with CKD requires explicit information about the risk factors that lead to adverse outcomes. In addition to biological influences, the socioeconomic circumstances of caregivers may play a significant role in the health and well-being of children with CKD.


METHODS
A prospective cohort study (n=380 children and n=380 caregivers) will be conducted to determine the prevalence of economic hardship among caregivers of children with CKD. All participants will be followed biennially over a period of 5 years to determine the association between the changing socioeconomic status of the caregivers and the health and overall well-being of school-aged children with CKD. Face to face, semi-structured interviews with the caregivers (n=45) will also be conducted to understand their perspectives on the economic, financial and psychosocial impact of CKD and how this affects the health outcomes of their child with CKD. The primary outcomes of the study are the effects of the socioeconomic status of the caregivers and self-reported health status of the children. Secondary outcomes included the prevalence of economic hardship and the distribution of wealth among the caregivers of children with CKD.


CONCLUSIONS
Findings from this study presents not only a snapshot of the current economic and social situation of the caregivers of children and adolescents with CKD but will also provide definitive evidence of determining whether a link between socioeconomic status of caregivers and outcomes of children with CKD exists.
Centre for Kidney Research, Kids Research Institute, The Children's Hospital at Westmead, Sydney, Australia. germaine.wong@health.nsw.gov.au.
Germaine
G
Wong
Meredith
M
Medway
Madeleine
M
Didsbury
Allison
A
Tong
Robin
R
Turner
Fiona
F
Mackie
Steven
S
McTaggart
Amanda
A
Walker
Sarah
S
White
Kirsten
K
Howard
Siah
S
Kim
Jonathan C
JC
Craig
D000293:Adolescent; D001315:Australia / Q000453:epidemiology; D001991:Bronchitis / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000453:epidemiology; D017028:Caregivers / Q000191:economics*; D002648:Child; D002985:Clinical Protocols; D015331:Cohort Studies; D015897:Comorbidity; D017281:Cost of Illness; D018450:Disease Progression; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D016030:Kidney Transplantation / Q000191:economics; D008297:Male; D063868:Patient Outcome Assessment; D011203:Poverty / Q000706:statistics & numerical data; D015995:Prevalence; D011446:Prospective Studies; D011788:Quality of Life; D006435:Renal Dialysis / Q000191:economics / Q000523:psychology; D051436:Renal Insufficiency, Chronic / Q000191:economics* / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D057566:Self Report; D012959:Socioeconomic Factors