Depressive Symptoms in Children with Chronic Kidney Disease

详细信息    查看全文

• 作者：Amy J. Kogon ; MD ; MPH¹ ; Matthew B. Matheson ; MS² ; Joseph T. Flynn ; MD ; MS³ ; Arlene C. Gerson ; PhD⁴ ; Bradley A. Warady ; MD⁵ ; Susan L. Furth ; MD ; PhD⁶ ; Stephen R. Hooper ; PhD⁷ ; for the Chronic Kidney Disease in Children (CKiD) Study Group^&lowast ; Bradley Warady ; MD ; Allison Dart ; MD ; MSc ; FRCPC ; Larry Greenbaum ; MD ; PhD ; Bradley Warady ; MD ; Jens Goebel ; MD ; Mark Mitsnefes ; MD ; Joseph Flynn ; MD ; Craig Wong ; MD ; Sahar Fathallah ; MD ; Isidro Salusky ; MD ; Ora Yadin ; MD ; Katherine Dell ; MD ; Bruce Morgenstern ; MD ; Tom Blydt-Hansen ; MD ; FRCPC ; Cynthia Pan ; MD ; Keefe Davis ; MD ; Amira Al-Uzri ; MD ; Randall Jenkins ; MD ; Anthony Portale ; MD ; Mouin Seikaly ; MD ; Martin Turman ; MD ; PhD ; Cynthia Wong ; MD ; Steven Alexander ; MD ; Colleen Hastings ; MD ; Randall Jenkins ; MD ; Nancy Rodig ; MD ; William Harmon ; MD ; Sharon Bartosh ; MD ; Nadine Benador ; MD ; Robert Mak ; MD ; PhD ; Ellen Wood ; MD ; Randall Jenkins ; MD ; Gary Lerner ; MD ; Susan Furth ; MD ; PhD ; Susan Furth ; MD ; PhD ; Susan Massengill ; MD ; Guillermo Hidalgo ; MD ; Meredith Atkinson ; MD ; Debbie Gipson ; MD ; Poyyapakkam Srivaths ; MD ; Joshua Samuels ; MD ; Frederick Kaskel ; MD ; PhD ; Debora Mattosian ; MD ; Yi Cai ; MD ; Sharon Andreoli ; MD ; PhD ; Jeffrey Saland ; MD ; Amy Kogon ; MD ; Victoria Norwood ; MD ; Rulan Parekh ; MD ; Lisa Robinson ; MD ; Susan Mendley ; MD ; Marc Lande ; MD ; George Schwartz ; MD ; Patrick Brophy ; MD ; Eunice John ; MD ; Kiran Upadhyay ; MD ; Maria Ferris ; MD ; Tej Matoo ; MD ; Juan Kupferman ; MD ; Lynne Weiss ; MD ; Craig Langman ; MD ; Patricia Seo-Mayer ; MD ; Kanwal Kher ; MD ; Dmitry Samsonov ; MD
• 关键词：CDI ; Children's Depression Inventory ; CKD ; Chronic kidney disease ; CKiD ; Chronic Kidney Disease in Children ; GFR ; Glomerular filtration rate ; HRQoL ; Health-related quality of life ; PedsQL ; Pediatric Inventory of Quality of Life Core Scales 4.0 ; RRT ; Renal replacement therapy
• 刊名：The Journal of Pediatrics
• 出版年：2016
• 出版时间：January 2016
• 年：2016
• 卷：168
• 期：Complete
• 页码：164-170.e1
• 全文大小：458 K

文摘

To assess depression in children with chronic kidney disease and to determine associations with patient characteristics, intellectual and educational levels, and health-related quality of life (HRQoL).

Study design

Subjects aged 6-17 years from the Chronic Kidney Disease in Children cohort study completed the Children's Depression Inventory (CDI), Wechsler Abbreviated Scales of Intelligence, Wechsler Individual Achievement Test-II-Abbreviated, and the Pediatric Inventory of Quality of Life Core Scales 4.0. Regression analyses determined associations of CDI score and depression status with subject characteristics, intellectual and educational levels, and HRQoL. A joint linear mixed model and Weibull model were used to determine the effects of CDI score on longitudinal changes in glomerular filtration rate and time to renal replacement therapy.

Results

A total of 344 subjects completed the CDI. Eighteen (5%) had elevated depressive symptoms, and another 7 (2%) were being treated for depression. In adjusted analyses, maternal education beyond high school was associated with 5% lower CDI scores (estimate, 0.95; 95% CI, 0.92-0.99). Depression status was associated with lower IQ (99 vs 88; P = .053), lower achievement (95 vs 77.5; P < .05), and lower HRQoL by parent and child reports (effect estimates, −15.48; 95% CI, −28.71 to −2.24 and −18.39; 95% CI, −27.81 to −8.96, respectively). CDI score was not related to change in glomerular filtration rate.

Conclusion

Children with depression had lower psychoeducational skills and worse HRQoL. Identifying and treating depression should be evaluated as a means of improving the academic performance and HRQoL of children with chronic kidney disease.