HEALTH-RELATED QUALITY OF LIFE OF PEDIATRIC END-STAGE RENAL DISEASE PATIENTS UNDERGOING DIALYSIS IN A GOVERNMENT HOSPITAL

 

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https://storage.unitedwebnetwork.com/files/1099/14776b1ba3dfdda5d1d304763202df40.pdf
HEALTH-RELATED QUALITY OF LIFE OF PEDIATRIC END-STAGE RENAL DISEASE PATIENTS UNDERGOING DIALYSIS IN A GOVERNMENT HOSPITAL

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Claire
Cania
Claire Cania clairegcania@gmail.com Southern Philippines Medical Center Pediatric Nephrology Davao City Philippines *
Michael Manalaysay docmtm@gmail.com Southern Philippines Medical Center Pediatric Nephrology Davao City Philippines -
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Background: Chronic kidney disease (CKD) has been defined as a condition in which an initial injury leads to a gradual, chronic process of decreasing function, eventually necessitating renal replacement therapy in the most extreme cases.1 Health-related quality of life (HRQoL) is increasingly recognized as a key outcome in clinical and research settings in the pediatric population with end-stage renal disease (ESRD).

 

Objective: This study aims to determine the HRQoL of adolescent Filipinos with End-stage Renal Disease (ESRD) undergoing dialysis in a tertiary government hospital.

 

Methods: The Hospital Research Ethics Committee reviewed and approved the study. A total of 19 dyadic pairing of pediatric ESRD patients undergoing either peritoneal dialysis or hemodialysis, and their parents, participated in the survey using a validated 34-item Pediatric Quality of Life InventoryTM End-Stage Renal Disease (PedsQLTM ESRD) module in Bisaya covering seven domains: General fatigue; knowledge about the disease; Treatment problems; Family and peer interaction; Level of anxiety, and Perceived physical appearance. Categorical variables were presented as frequency andpercentage. Shapiro-Wilk test and Levene’s test determined theassumptions of normality and homogeneity of continuous variables. Continuous data that met normality assumptions were summarized by mean and SD, while non-normally distributed data were described by median and interquartile range. PedsQL scores between hemodialysis and peritoneal dialysis groups were compared using an independent t-test, with the null hypothesis rejected at the 0.05 significance level. Data analysis was performed using STATA 15.0.

Results: Pediatric ESRD patients from a tertiary government hospital participated in the study (n=19), mostly male, with a mean age of 15.05 years (± 2.32), with majority (78.9%) in junior high school and residing in Davao City and Davao Gulf provinces. All patients were classified as G3A-G5, with a mean disease duration of 2.68 years (± 1.96). All parents were employed, with a median salary of Php 9,000. There were no significant differences in clinic-sociodemographic characteristics between patients on peritoneal dialysis (PD) and hemodialysis (HD).

Regarding quality of life (QoL) self-assessments, there were no significant differences in overall QoL scores (63.12 ± 11.68; p > 0.05) across various domains, including (65.13 ± 26.95; p=.491); “knowledge about the disease” (68.95 ± 17.76; p=.169); “treatment problems” (68.75 ± 19.98; p=.199); “family and peer interaction” (56.58 ± 24.47; p=.614); “level of anxiety” (54.34 ± 13.71; p=.864); “perceived physical appearance” (72.37 ± 20.98; p=.322), and “problems with communication” (67.11 ± 17.82; p=.673). Similarly, no significant differences were found in health-related QoL scores using the PedsQLESRD module between PD (65.63 ± 9.22) and HD (61.30 ± 13.32) groups (p = 0.422), or in parent-reported proxy assessments (PD = 65.17 ± 10.93 vs. HD = 60.36 ± 14.21; p = 0.436).

 


Conclusion: ESRD and and the type of treatment administeredaffect the health-related quality of life (HRQoL) in pediatric patients, leading to physical, mental, and emotional challenges. Regular HRQoL assessments using the 34-item Peds QLTM ESRD module, including patient-reported outcomes, should be integrated into standard care to identify areas for intervention.

Kewords