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J Pediatr. 2016 Jan;168:164-70.e1. doi: 10.1016/j.jpeds.2015.09.040. Epub 2015 Oct 23.

Depressive Symptoms in Children with Chronic Kidney Disease.

Author information

1
Division of Pediatric Nephrology, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH.
2
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
3
Division of Pediatric Nephrology, Seattle Children's Hospital, University of Washington, Seattle, WA.
4
Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD.
5
Division of Pediatric Nephrology, Children's Mercy Hospital, Kansas City, MO.
6
Division of Pediatric Nephrology, Children's Hospital of Philadelphia, Philadelphia, PA.
7
Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, NC.

Abstract

OBJECTIVE:

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.

PMID:
26505290
PMCID:
PMC4854431
DOI:
10.1016/j.jpeds.2015.09.040
[Indexed for MEDLINE]
Free PMC Article

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