Evaluating construct validity of the PRO-Kid life participation tool for children living with chronic kidney disease

Life participation is a priority outcome for children and families living with chronic kidney disease (CKD). This study aimed to assess the construct validity of the PRO-Kid-LP, a novel three-item tool measuring CKD's impact on children's life participation.

Participants were children aged 8-18 years from Canada, with stages 3-5 CKD, who were part of the PRO-Kid validation cohort. Using 5-point adjectival scales, the PRO-Kid-LP tool measures CKD's impact on three domains over 1 week: (1) school participation, (2) meaningful time with family and friends, (3) participation in hobbies/recreational activities. Higher scores reflected more impact of CKD on life participation. The PedsQL™ and PRO-Kid symptom assessment tool were also completed. Construct validity was evaluated with Spearman correlations and internal consistency, with Cronbach's alpha (C_α).

Ninety-seven children were included, with a mean age of 14.4 years (IQR 11, 16.6), and 62.9% (61/97) were male. Impact on life participation increased by CKD stage (p = 0.003). There was an inverse relationship between PRO-Kid-LP and PedsQL™ scores (r =  - 0.65, p < 0.001), and a positive relationship between PRO-Kid-LP scores and CKD symptoms (PRO-Kid frequency [r = 0.51, p < 0.001] and impact [r = 0.49, p < 0.001] scores). PRO-Kid-LP scores were associated with the PRO-Kid "Feeling left out" item (p < 0.001). Internal consistency was high (C_α = 0.81), which supports reliability.

This study supports the validity of the PRO-Kid-LP to quantify the impact of CKD on life participation in children with stages 3-5 CKD. The tool shows internal consistency, a positive correlation with symptom burden, and a negative correlation with quality of life.