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Rising Star Poster/Presentation

Abstract

Background: Childhood chronic kidney disease (CKD) affects an estimated 15 to 75 children and adolescents per million worldwide. As a disease and symptom multiplier, childhood CKD is burdensome and leads to decreased quality of life. It is essential to explore current knowledge of the symptom experience in adolescents with CKD to help reduce burden and improve quality of life. The purpose of this systematic review was to explore the state of the science of the symptom experiences in children and adolescents with conservatively managed CKD.

Methods: This systematic review included articles identified through searches in Scopus, PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL) Complete, PsycINFO (EBSCO) in October 2024. Included articles were English language, peer-reviewed, descriptive, full-length original research articles. Article appraisal and risk of bias was assessed by two independent reviewers using the Johns Hopkins Nursing Evidence-Based Practice Research Appraisal Tool.

Results: 1,522 articles were screened and eight met criteria for review and investigated the presence of at least one CKD associated symptom in 1,084 (426 female, 658 male) children and adolescents. Symptoms studied most frequently across articles included anxiety and depressive symptoms (62.5%, respectively), followed by fatigue, sleep disturbances, pain, mobility difficulties, and peer relationships. Other symptoms included changes in mood, behavior and cognitive functioning, gastrointestinal and nutritional disturbances, fluid shift imbalances, and other (fever, vison changes, acne, restless legs). Symptoms in children and adolescents with CKD were often compared to healthy age-matched peers or those with inactive disease (remission). The pediatric Patient-Reported Outcome Measurement Information System® (PROMIS®) measures were most common, used in three (37.5%) of the included articles.

Conclusions: The low number of articles, varying symptoms and symptom domains studied, and varying symptom measures indicate there is very little consensus on conceptual or operational issues related to symptoms reported by children and adolescents with CKD. Furthermore, there are varying methods of describing (intensity, severity, prevalence) and reporting (composite score, numeric value) symptom domains. Additional research of symptoms is essential to guide therapeutic management of CKD effectively and improve the quality of life in children and adolescents with CKD.

Description

Childhood chronic kidney disease (CKD) is burdensome and may lead to lifelong challenges including por symptom management and decreased quality of life. It is important to understand the self-reported symptom experience in this population to improve health outcomes. This systematic review explored the varying symptoms experienced and the conceptional and operational challenges in measuring and reporting symptoms in children and adolescents with CKD.

Author Details

Rileigh M. Fagan, BSN; Janet S. Carpenter, PhD, RN, FAAN; Heather K. Hardin, PhD, RN; Rebecca J. Bartlett Ellis, PhD, RN

Sigma Membership

Alpha

Type

Poster

Format Type

Text-based Document

Study Design/Type

Systematic Review

Research Approach

Other

Keywords:

Childhood Chronic Kidney Disease, CKD, Adolescents, CKD Symptoms

Conference Name

36th International Nursing Research Congress

Conference Host

Sigma Theta Tau International

Conference Location

Seattle, Washington, USA

Conference Year

2025

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

Review Type

Invited Presentation

Acquisition

Proxy-submission

Click on the above link to access the poster.

Additional Files

References.pdf (131 kB)

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A Systematic Review of Symptoms in Adolescents with CKD

Seattle, Washington, USA

Background: Childhood chronic kidney disease (CKD) affects an estimated 15 to 75 children and adolescents per million worldwide. As a disease and symptom multiplier, childhood CKD is burdensome and leads to decreased quality of life. It is essential to explore current knowledge of the symptom experience in adolescents with CKD to help reduce burden and improve quality of life. The purpose of this systematic review was to explore the state of the science of the symptom experiences in children and adolescents with conservatively managed CKD.

Methods: This systematic review included articles identified through searches in Scopus, PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL) Complete, PsycINFO (EBSCO) in October 2024. Included articles were English language, peer-reviewed, descriptive, full-length original research articles. Article appraisal and risk of bias was assessed by two independent reviewers using the Johns Hopkins Nursing Evidence-Based Practice Research Appraisal Tool.

Results: 1,522 articles were screened and eight met criteria for review and investigated the presence of at least one CKD associated symptom in 1,084 (426 female, 658 male) children and adolescents. Symptoms studied most frequently across articles included anxiety and depressive symptoms (62.5%, respectively), followed by fatigue, sleep disturbances, pain, mobility difficulties, and peer relationships. Other symptoms included changes in mood, behavior and cognitive functioning, gastrointestinal and nutritional disturbances, fluid shift imbalances, and other (fever, vison changes, acne, restless legs). Symptoms in children and adolescents with CKD were often compared to healthy age-matched peers or those with inactive disease (remission). The pediatric Patient-Reported Outcome Measurement Information System® (PROMIS®) measures were most common, used in three (37.5%) of the included articles.

Conclusions: The low number of articles, varying symptoms and symptom domains studied, and varying symptom measures indicate there is very little consensus on conceptual or operational issues related to symptoms reported by children and adolescents with CKD. Furthermore, there are varying methods of describing (intensity, severity, prevalence) and reporting (composite score, numeric value) symptom domains. Additional research of symptoms is essential to guide therapeutic management of CKD effectively and improve the quality of life in children and adolescents with CKD.