TY - JOUR
T1 - A longitudinal analysis of the effect of anemia on health-related quality of life in children with mild-to-moderate chronic kidney disease
AU - Carlson, Joann
AU - Gerson, Arlene C.
AU - Matheson, Matthew B.
AU - Manne, Sharon
AU - Warady, Bradley A.
AU - Hooper, Stephen R.
AU - Lande, Marc
AU - Harshman, Lyndsay A.
AU - Johnson, Rebecca J.
AU - Shinnar, Shlomo
AU - Kogon, Amy J.
AU - Furth, Susan
N1 - Publisher Copyright:
© 2020, IPNA.
PY - 2020/9/1
Y1 - 2020/9/1
N2 - Background: To evaluate impact of anemia on health-related quality of life (HRQOL) over time in a large pediatric cohort with mild-to-moderate chronic kidney disease (CKD). Methods: Participants were enrolled in the Chronic Kidney Disease in Children Study (CKiD), a multicenter, longitudinal cohort. HRQOL was measured using the Pediatric Quality of Life Inventory (PedsQL). Anemia was defined as hemoglobin < 5th percentile for age, sex, and race. Two longitudinal analyses were conducted on consecutive visit pairs. Models examined effects of anemia status on both HRQOL score over time and change in HRQOL score between consecutive visits. The sample included 733 children with a median estimated GFR 54 ml/min/1.73 m2. Thirty percent of children had anemia at index visit. Results: Analysis of HRQOL scores revealed the presence of anemia was associated with significantly lower overall HRQOL (β = − 2.90 (95% CI = − 7.74, − 0.21), p = 0.04) and physical functioning (β = − 5.72 (− 9.49, − 2.25), p = 0.001) according to children. On parent ratings, the development of anemia was associated with lower emotional functioning scores (β = − 4.87 (− 8.72, − 0.11), p = 0.045). In the second model, children who developed anemia were rated by caregivers as having more decreased physical functioning than children who remained anemia-free (β = − 3.30 per year (− 5.83, − 0.76), p = 0.01). Caregivers did not observe declines in their children’s other PedsQL subscales in the presence of developed anemia. Children with resolved or persistence did not show improvement or decline in any aspect of HRQOL functioning relative to non-anemic subjects. Conclusions: In children with CKD, anemia has an adverse effect on HRQOL which persists over time but does not appear to be progressive.
AB - Background: To evaluate impact of anemia on health-related quality of life (HRQOL) over time in a large pediatric cohort with mild-to-moderate chronic kidney disease (CKD). Methods: Participants were enrolled in the Chronic Kidney Disease in Children Study (CKiD), a multicenter, longitudinal cohort. HRQOL was measured using the Pediatric Quality of Life Inventory (PedsQL). Anemia was defined as hemoglobin < 5th percentile for age, sex, and race. Two longitudinal analyses were conducted on consecutive visit pairs. Models examined effects of anemia status on both HRQOL score over time and change in HRQOL score between consecutive visits. The sample included 733 children with a median estimated GFR 54 ml/min/1.73 m2. Thirty percent of children had anemia at index visit. Results: Analysis of HRQOL scores revealed the presence of anemia was associated with significantly lower overall HRQOL (β = − 2.90 (95% CI = − 7.74, − 0.21), p = 0.04) and physical functioning (β = − 5.72 (− 9.49, − 2.25), p = 0.001) according to children. On parent ratings, the development of anemia was associated with lower emotional functioning scores (β = − 4.87 (− 8.72, − 0.11), p = 0.045). In the second model, children who developed anemia were rated by caregivers as having more decreased physical functioning than children who remained anemia-free (β = − 3.30 per year (− 5.83, − 0.76), p = 0.01). Caregivers did not observe declines in their children’s other PedsQL subscales in the presence of developed anemia. Children with resolved or persistence did not show improvement or decline in any aspect of HRQOL functioning relative to non-anemic subjects. Conclusions: In children with CKD, anemia has an adverse effect on HRQOL which persists over time but does not appear to be progressive.
KW - Hemoglobin
KW - Kidney disease progression
KW - Longitudinal
KW - Parent-child agreement
KW - PedsQL
KW - Psychosocial
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U2 - 10.1007/s00467-020-04569-5
DO - 10.1007/s00467-020-04569-5
M3 - Article
C2 - 32333284
AN - SCOPUS:85084145453
SN - 0931-041X
VL - 35
SP - 1659
EP - 1667
JO - Pediatric Nephrology
JF - Pediatric Nephrology
IS - 9
ER -