TY - JOUR
T1 - Sleep and Fatigue Symptoms in Children and Adolescents With CKD
T2 - A Cross-sectional Analysis From the Chronic Kidney Disease in Children (CKiD) Study
AU - Roumelioti, Maria Eleni
AU - Wentz, Alicia
AU - Schneider, Michael F.
AU - Gerson, Arlene C.
AU - Hooper, Stephen
AU - Benfield, Mark
AU - Warady, Bradley A.
AU - Furth, Susan L.
AU - Unruh, Mark L.
N1 - Funding Information:
Support: The CKiD Study is funded by the National Institute of Diabetes and Digestive and Kidney Diseases, with additional funding from the National Institute of Neurological Disorders and Stroke , the National Institute of Child Health and Human Development , and the National Heart, Lung, and Blood Institute (grants UO1-DK-66143 , UO1-DK-66174 , and UO1-DK-66116 ). Preparation of this article was supported by the Norman S. Coplon extramural grant program of Satellite Healthcare Inc.
PY - 2010/2
Y1 - 2010/2
N2 - Background: Although symptoms of sleepiness and fatigue are common in adults with chronic kidney disease (CKD), little is known about the prevalence of these symptoms in children with CKD. Study Design: Cross-sectional analysis within a cohort study. Setting & Participants: We describe the frequency and severity of sleep problems and fatigue and assess the extent of their association with measured glomerular filtration rate (mGFR) and health-related quality of life (HRQOL) in 301 participants of the Chronic Kidney Disease in Children cohort. Outcomes & Measurements: Sleep and fatigue-related items from the Pediatric Quality of Life Inventory 4.0 Generic Scales and the CKD-related Symptoms List were used. Results: Median mGFR was 42.0 mL/min/1.73 m2 (25th-75th percentiles, 31.2-53.2), and median age was 13.9 years (25th-75th percentiles, 10.8-16.2). Children with mGFR of 40-<50, 30-<40, or <30 mL/min/1.73 m2 had 2.07 (95% CI, 1.05-4.09), 2.35 (95% CI, 1.17-4.72), and 2.59 (95% CI, 1.15-5.85) higher odds of having more severe parent reports of low energy than children with mGFR ≥ 50 mL/min/1.73 m2. Compared with participants with mGFR ≥ 50 mL/min/1.73 m2, those with mGFR < 30 mL/min/1.73 m2 had 3.92 (95% CI, 1.37-11.17) higher odds of reporting more severe weakness, and those with mGFR of 40-<50 mL/min/1.73 m2 had 2.95 (95% CI, 1.26-6.88) higher odds of falling asleep during the day. Low energy, trouble sleeping, and weakness were associated with lower HRQOL scores. Limitations: Symptoms of sleep and fatigue represent the child's or parent's perception of symptom severity, whereas individual items can lead to imprecise measurements of sleep and fatigue. Conclusions: Lower mGFR was associated with increased weakness, low energy, and daytime sleepiness. Furthermore, a strong association between trouble sleeping, low energy, and weakness with decreases in overall HRQOL was observed. Detection and treatment of poor sleep and fatigue may improve the development and HRQOL of children and adolescents with CKD.
AB - Background: Although symptoms of sleepiness and fatigue are common in adults with chronic kidney disease (CKD), little is known about the prevalence of these symptoms in children with CKD. Study Design: Cross-sectional analysis within a cohort study. Setting & Participants: We describe the frequency and severity of sleep problems and fatigue and assess the extent of their association with measured glomerular filtration rate (mGFR) and health-related quality of life (HRQOL) in 301 participants of the Chronic Kidney Disease in Children cohort. Outcomes & Measurements: Sleep and fatigue-related items from the Pediatric Quality of Life Inventory 4.0 Generic Scales and the CKD-related Symptoms List were used. Results: Median mGFR was 42.0 mL/min/1.73 m2 (25th-75th percentiles, 31.2-53.2), and median age was 13.9 years (25th-75th percentiles, 10.8-16.2). Children with mGFR of 40-<50, 30-<40, or <30 mL/min/1.73 m2 had 2.07 (95% CI, 1.05-4.09), 2.35 (95% CI, 1.17-4.72), and 2.59 (95% CI, 1.15-5.85) higher odds of having more severe parent reports of low energy than children with mGFR ≥ 50 mL/min/1.73 m2. Compared with participants with mGFR ≥ 50 mL/min/1.73 m2, those with mGFR < 30 mL/min/1.73 m2 had 3.92 (95% CI, 1.37-11.17) higher odds of reporting more severe weakness, and those with mGFR of 40-<50 mL/min/1.73 m2 had 2.95 (95% CI, 1.26-6.88) higher odds of falling asleep during the day. Low energy, trouble sleeping, and weakness were associated with lower HRQOL scores. Limitations: Symptoms of sleep and fatigue represent the child's or parent's perception of symptom severity, whereas individual items can lead to imprecise measurements of sleep and fatigue. Conclusions: Lower mGFR was associated with increased weakness, low energy, and daytime sleepiness. Furthermore, a strong association between trouble sleeping, low energy, and weakness with decreases in overall HRQOL was observed. Detection and treatment of poor sleep and fatigue may improve the development and HRQOL of children and adolescents with CKD.
KW - Children
KW - adolescents
KW - chronic kidney disease
KW - fatigue
KW - glomerular filtration rate
KW - health-related quality of life
KW - sleep
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U2 - 10.1053/j.ajkd.2009.09.021
DO - 10.1053/j.ajkd.2009.09.021
M3 - Article
C2 - 20034719
AN - SCOPUS:74449092733
VL - 55
SP - 269
EP - 280
JO - American Journal of Kidney Diseases
JF - American Journal of Kidney Diseases
SN - 0272-6386
IS - 2
ER -