McKenna Ann Marie, Keating Laura E, Vigneux Annette, Stevens Sarah, Williams Angela, Geary Denis F
Division of Nephrology, Hospital for Sick Children, Toronto M5G 1X8, ON, Canada.
Nephrol Dial Transplant. 2006 Jul;21(7):1899-905. doi: 10.1093/ndt/gfl091. Epub 2006 Apr 12.
Children with chronic kidney disease (CKD) require strict dietary and lifestyle modifications, however, there is little information on their quality of life. Our objective was to compare health-related quality of life (HRQOL) in children with different stages of CKD to each other and to a control population.
A cross-sectional assessment of HRQOL for physical, emotional, social and school domains was performed using the PedsQL Generic Core Scale. Data were collected from 20 children with chronic renal insufficiency (CRI; creatinine > 200 micromol/l), 12 on maintenance haemodialysis or peritoneal dialysis (DIAL) and 27 with renal transplants (TX). Caregiver proxy reports were obtained for CRI (n = 20), DIAL (n = 17) and TX (n = 21). Between-group differences were assessed with ANOVA for the CKD groups; t-tests compared our CKD samples with controls.
Children with CKD scored lower than the controls in all subscales, however, only TX compared with controls was significant (P < 0.02). DIAL children scored equal to or higher than the TX group in all domains. Analysis of covariance with number of medications as covariate yielded a significant result for the physical subscale (F = 8.95, df = 3, 53, P = 0.004). Proxy caregiver scores were lower than patient scores in all four domains.
Children with CKD rate their HRQOL lower than the healthy controls do. It may be reassuring to caregivers that children on dialysis rate their HRQOL higher than would be expected. However, it is of some concern that caregiver perception of improved HRQOL following transplantation was not shared by their children in the present study.
慢性肾脏病（CKD）患儿需要严格的饮食和生活方式调整，然而，关于他们的生活质量的信息却很少。我们的目的是比较不同阶段CKD患儿之间以及与对照组人群的健康相关生活质量（HRQOL）。
使用儿童生活质量普适核心量表对身体、情感、社会和学校领域的HRQOL进行横断面评估。收集了20例慢性肾功能不全（CRI；肌酐>200微摩尔/升）患儿、12例维持性血液透析或腹膜透析（DIAL）患儿和27例肾移植（TX）患儿的数据。获得了CRI组（n = 20）、DIAL组（n = 17）和TX组（n = 21）的照顾者代理报告。对CKD组进行方差分析评估组间差异；t检验将我们的CKD样本与对照组进行比较。
CKD患儿在所有子量表中的得分均低于对照组，然而，只有TX组与对照组相比差异有统计学意义（P < 0.02）。DIAL组患儿在所有领域的得分等于或高于TX组。以药物数量作为协变量进行协方差分析，身体子量表得出显著结果（F = 8.95，df = 3，53，P = 0.004）。在所有四个领域中，照顾者代理评分均低于患者评分。
CKD患儿对其HRQOL的评分低于健康对照组。透析患儿对其HRQOL的评分高于预期，这可能会让照顾者放心。然而，在本研究中，照顾者认为移植后HRQOL有所改善，但他们的孩子却并非如此，这令人有些担忧。
