Children on dialysis as well as renal transplanted children report severely impaired health-related quality of life

• Published in: Quality of life research 2018-06, Vol.27 (6), p.1445-1454
• Main Authors: Splinter, Anouck, Tjaden, Lidwien A., Haverman, Lotte, Adams, Brigitte, Collard, Laure, Cransberg, Karlien, van Dyck, Maria, Van Hoeck, Koen J., Hoppe, Bernd, Koster-Kamphuis, Linda, Lilien, Marc R., Raes, Ann, Taylan, Christina, Grootenhuis, Martha A., Groothoff, Jaap W.
• Format: Article
• Language: English
• Subjects: Adolescents; CHILD HEALTH; Chronic illnesses; End-stage renal disease; Health-related quality of life; Hemodialysis; Human health sciences; Kidney diseases; Medicine; Medicine & Public Health; Pediatrics; Public Health; Pédiatrie; Quality of life; Quality of Life Research; Renal replacement therapy; Sciences de la santé humaine; Sociology; Teenagers; Transplants & implants; Urologie & néphrologie; Urology & nephrology
• ISSN: 0962-9343; 1573-2649; 1573-2649
• DOI: 10.1007/s11136-018-1789-4

Objectives To assess health-related quality of life (HRQoL) across three renal replacement therapy modalities (preemptive transplant, non-preemptive transplant, and dialysis) in comparison with the healthy norm and other chronic health conditions, and to explore related patient factors. Study design All prevalent end-stage renal disease (ESRD) patients aged 8-18 years who spent at least 6 months on their current treatment modality in the Netherlands, Belgium, and part of Germany were approached to complete the Pediatrie Quality of Life Inventory 4.0 (PedsQL™) questionnaire. We determined the differences between groups on PedsQL™ mean scores, the proportion of children with an impaired HRQoL (≥ 1 SD lower than the healthy norm), the proportion of problems on individual items of the PedsQLT™, and the effect of time on current treatment. Linear regression models were used to explore determinants of HRQoL. Results 192 out of 278 patients (20% preemptive transplant, 58% non-preemptive transplant, 22% dialysis) filled in the PedsQL™ (response rate 69%). Independent of treatment modality, patients had significantly lower mean scores and consequently higher proportions of impaired HRQoL on almost all domains compared to the healthy norm and other chronic health conditions. Patients with a preemptive transplant only reported higher scores on physical health compared to the other treatment modalities. Having comorbidities was the most important determinant associated with lower HRQoL scores. Conclusion Dialysis and renal transplantation both have a severe impact on the HRQoL of children with ESRD. Physicians should be aware of this continuous burden. Furthermore, to develop tailored interventions for children with ESRD, qualitative studies are needed to gain more insight in the determinants of HRQoL in the different treatment modalities.