Wijaya Elrika Anastasia, Solek Purboyo, Rachmadi Dedi, Rahayuningsih Sri Endah, Tarigan Rodman, Hilmanto Dany
Department of Child Health, Faculty of Medicine, Universitas Padjadjaran, Hasan Sadikin General Hospital, Bandung, West Java, Indonesia.
Int J Nephrol Renovasc Dis. 2024 Jan 8;17:17-28. doi: 10.2147/IJNRD.S428657. eCollection 2024.
As the highest function in the brain that regulates our daily activity, executive dysfunction might affect someone's health-related quality of life (HRQoL), especially in those with chronic diseases, including chronic kidney disease (CKD). Neurocognitive functions, including intelligence quotient (IQ) and executive function can be affected through various mechanisms in CKD. However, there was still no specific study regarding how IQ and executive function might affect HRQoL in children with CKD.
To assess Executive Function's impact on HRQoL and to find association between treatment modalities and CKD stages with HRQoL in children with CKD.
A cross sectional study was conducted at Pediatric Nephrology Clinic at Hasan Sadikin General Hospital, Bandung, Indonesia from September 2022 to April 2023. We included 38 children whose age range were 6-16 years 11 months old with CKD stage III - V. Assessment tools used were: BRIEF questionnaire for executive function; WISC III tool for IQ; PedsQL questionnaire generic module for HRQoL. Data was analyzed using SPSS ver. 26.0.
Total number of samples was 38. Complete examinations were done on 30 patients. Eight other patients did not undergo the IQ test. There was a negative correlation between executive function components scores (GEC, BRI, MI) with HRQoL scores on parents' proxy in all domains. We found no correlation between HRQoL and IQ scores, but we found a correlation between IQ and CKD stage. There was a significant difference in HRQoL from the children's perspective among the three modalities; children who underwent conservative treatment were having the best HRQoL scores.
Interventions to improve executive function of children with CKD should be done to improve their HRQoL in the future. Early diagnosis and treatment of CKD should be done at the earliest to improve neurocognitive function and HRQoL.
作为大脑中调节我们日常活动的最高功能，执行功能障碍可能会影响某人与健康相关的生活质量（HRQoL），尤其是在患有慢性疾病的人群中，包括慢性肾脏病（CKD）。慢性肾脏病可通过多种机制影响神经认知功能，包括智商（IQ）和执行功能。然而，关于智商和执行功能如何影响慢性肾脏病儿童的健康相关生活质量，仍没有具体的研究。
评估执行功能对健康相关生活质量的影响，并找出慢性肾脏病儿童的治疗方式和慢性肾脏病分期与健康相关生活质量之间的关联。
2022年9月至2023年4月，在印度尼西亚万隆哈桑·萨迪金综合医院的儿科肾脏病诊所进行了一项横断面研究。我们纳入了38名年龄在6至16岁11个月的慢性肾脏病III - V期儿童。使用的评估工具包括：用于执行功能的BRIEF问卷；用于智商的韦氏儿童智力量表第三版（WISC III）工具；用于健康相关生活质量的儿童生活质量量表（PedsQL）通用模块。数据使用SPSS 26.0版进行分析。
样本总数为38例。30例患者完成了全面检查。另外8例患者未进行智商测试。在所有领域，执行功能组成部分得分（GEC、BRI、MI）与家长代理的健康相关生活质量得分之间存在负相关。我们发现健康相关生活质量与智商得分之间没有相关性，但发现智商与慢性肾脏病分期之间存在相关性。三种治疗方式在儿童视角下健康相关生活质量存在显著差异；接受保守治疗的儿童健康相关生活质量得分最佳。
未来应采取干预措施改善慢性肾脏病儿童的执行功能，以提高他们的健康相关生活质量。应尽早对慢性肾脏病进行早期诊断和治疗，以改善神经认知功能和健康相关生活质量。
