Campbell Drohan1,2, Anita Van Zwieten1,2, Kylie-Ann Mallitt1,2, Anne Durkan1,3, Deirdre Hahn1,3, Chandana Guha1,2, Rabia Khalid1,2, Jennifer Lorenzo4, Suncica Lah5, Madeleine Didsbury1,2, Anna Francis1,6, Steve McTaggart6, Amanda Walker7, Fiona E Mackie8, Chanel Prestidge9, Belinda Barton10, Armando Teixeira-Pinto1,2, Allison Jaure1,2, Natasha Nassar11, Jonathan C Craig1,11, Germaine Wong1,12, Siah Kim1,2
1Centre for Kidney Research, The Children’s Hospital At Westmead, Westmead, Australia, 2Sydney School of Public Health, Sydney Unviersity, Camperdown, Australia, 3Department of Nephrology, The Children’s Hospital at Westmead, Westmead, Australia, 4Kids Neuroscience Centre, The Children’s Hospital at Westmead, Westmead, Australia, 5School of Psychology, Sydney University, Camperdown, Australia, 6Child & Adolescent Renal Service, Queensland Children’s Hospital, Brisbane, Australia, 7Department of Nephrology, Royal Children’s Hospital, Parkville, Australia, 8Department of Nephrology, Sydney Children’s Hospital, Randwick, Australia, 9Department of Nephrology, Starship Children’s Hospital, Auckland, New Zealand, 10Children’s Hospital Education Research Institute, The Children’s Hospital at Westmead, Westmead, Australia, 11Child Population and Translational Health Research, Children’s Hospital at Westmead Clinical School, Sydney University, Westmead, Australia, 12College of Medicine and Public Health, Flinders University, Adelaide, Australia, 13Centre for Transplant and Renal Research, Westmead Hospital, Westmead, Australia
Background & Aims: Chronic kidney disease (CKD) and its treatment is associated with
psychosocial burdens in children. Despite the importance of childhood psychosocial
development, few studies have assessed emotional and
behavioural functioning in children across the full spectrum of CKD.
Methods: Participants with CKD were recruited from three Australian hospitals. The Behaviour Assessment System for Children (BASC-2) was used to assess psychosocial development in four areas: externalising problems (hyperactivity, aggression, conduct), internalising problems (anxiety, depression, somatisation), behavioural symptoms (atypicality, withdrawal, attention), and adaptive skills (adaptability, social skills, leadership, activities of daily living, functional communication). Multivariable logistic regression examined the association between CKD stage and behavioural outcomes.
Results: 53 participants with mean age of 12 years (s.d. 2.5) were included. 37(70%) were male and 27(51%) of children had CKD stages 1-5, 3(6%) were on dialysis and 22(42%) had a kidney transplant. A higher proportion of children with CKD were at risk for somatisation (25(47%)), withdrawal (18(33%)), depression (17(32%)) and reduced activities of daily living (17(32%)) compared to the general population. Participants on kidney replacement therapy(KRT) were more likely to have adaptive skill deficits (OR, 95% CI)(5.7, 1.07-30.5) compared to those with CKD stages 1-5. KRT was not associated with increased risk of internalising problems (1.1, 0.3 to 2.6) or behavioural symptoms (2.0, 0.4 to 9.4) but may increase risk of externalising problems (5.0, 0.85-29.5).
Conclusions: Children with CKD are at risk of somatisation, withdrawal, depression, and reduced activities of daily living. Adaptive skill deficits were found more commonly among children with KRT compared to children with CKD stages 1-5. Our work highlights the need for ongoing surveillance of behavioural and psychological issues in children with CKD.
Biography:
Bio to come