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Short stature and chronic renal failure: what concerns children and parents?
J M Reynolds1, A J Wood, D M Eminson
1Royal Manchester Children's Hospital, Department of Child and Adolescent Psychiatry.
Insights
Growth hormone treatment is being studied in children with chronic renal failure (CRF). Parents prioritize future health, while children focus on family impact, with growth being a concern for both groups.
Area of Science:
- Pediatric Nephrology
- Pediatric Endocrinology
- Child Psychology
Background:
- Children with chronic renal failure (CRF) often experience growth issues.
- Growth hormone (GH) treatment is being investigated for short children with CRF.
- Psychological well-being and concerns are critical in managing pediatric CRF.
Purpose of the Study:
- To assess the psychological functioning of children with CRF.
- To evaluate the concerns of children and parents regarding growth in the context of CRF.
- To understand how concerns differ between children and parents to improve treatment outcomes.
Main Methods:
- A qualitative study involving interviews with 30 children (2-18 years) and their parents across four centers.
- Participants had CRF, were on dialysis, or had undergone a transplant.
- Assessment of psychological functioning and specific concerns related to growth and illness.
Main Results:
- Children (24 males, 6 females) had a mean age of 2-18 years; 50% had non-renal complications, 30% had learning difficulties.
- Parents' primary concerns were future health (50%) and prospects (37%).
- Children's main concern was the impact of illness on their family (50%), with growth being a significant concern for both (30% parents, 28% children).
Conclusions:
- Psychological and growth concerns in pediatric CRF are multifaceted and differ between children and parents.
- Addressing these varied concerns is crucial for optimizing growth hormone therapy.
- A holistic approach considering psychosocial factors alongside medical management is essential for children with CRF.
Abstract:
Multicentre trials are evaluating growth hormone treatment in short children (height > 2 SDs below mean) with chronic renal failure (CRF), on dialysis, or with a transplant. Thirty children and parents from four centres were interviewed to assess psychological functioning and evaluate their concerns about growth in the context of CRF. There were 24 males and six females, age range 2-18 years. Fifty per cent of patients had additional non-renal complications and 30% had learning difficulties. Differences between the respective concerns of parents and children were striking. Parents' predominant concern was their child's future health (50%) and prospects (37%) while children's main concern was the impact of illness on their family (50%). Growth was a major concern for 30% of parents and 28% of children. Growth problems are important and should be considered within the context of other illness issues. Improved understanding of parental and child concerns may help maximise the benefits of growth hormone and assist in the management of children with CRF.