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Published on: June 16, 2014
Depressive Symptoms in Children with Chronic Kidney Disease
Amy J Kogon1, Matthew B Matheson2, Joseph T Flynn3
1Division of Pediatric Nephrology, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH.
Insights
Children with chronic kidney disease experiencing depression show lower academic skills and reduced quality of life. Early identification and treatment of depression may improve outcomes for these pediatric patients.
Area of Science:
- Pediatric Nephrology
- Child Psychology
- Health-Related Quality of Life Research
Background:
- Chronic kidney disease (CKD) significantly impacts children's well-being.
- Depression is a common comorbidity in pediatric CKD, affecting overall health outcomes.
- Understanding the factors associated with depression is crucial for comprehensive care.
Purpose of the Study:
- To evaluate depression prevalence in children with CKD.
- To examine the relationship between depression and patient characteristics, cognitive/educational levels, and health-related quality of life (HRQoL).
- To assess the impact of depression on renal function and progression.
Main Methods:
- Utilized data from the Chronic Kidney Disease in Children cohort study.
- Administered the Children's Depression Inventory (CDI), intelligence, and achievement tests.
- Employed regression analyses and mixed-effects models to assess associations and longitudinal effects.
Main Results:
- 5% of participants had elevated depressive symptoms; 2% were treated for depression.
- Depression was linked to lower IQ, reduced academic achievement, and poorer HRQoL.
- Maternal education was inversely associated with CDI scores; no effect on glomerular filtration rate change.
Conclusions:
- Children with CKD and depression exhibit diminished psychoeducational skills and HRQoL.
- Intervention for depression in pediatric CKD warrants consideration to enhance academic performance and quality of life.
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.
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