Social-behavioural functioning in paediatric chronic kidney disease

Background: The social-behavioural functioning of children and adolescents with chronic kidney disease (CKD) is not well studied and not fully understood, with available studies reflecting a mixed set of findings. The primary purpose of this paper is to compare the social-behavioural functioning of children with CKD with typical controls using multiple raters. A secondary analysis also examines the impact of disease severity on social-behavioural functioning. Methods: Parental ratings and self-reports on the Behavior Assessment System for Children were obtained from a patient sample of 26 children and adolescents with CKD. This sample was comprised of those with end-stage renal disease (end-stage renal disease; n = 13) and those with chronic renal insufficiency (n = 13). For comparison, a typically developing control group (n = 33) also was ascertained. Results: While behaviour ratings by parents and children fell within the average range, parent ratings showed an increased number of internalizing symptoms when compared with the CKD Group. Exploratory analyses revealed parental ratings showing more specific concerns on the Behavior Assessment System for Children individual clinical scales of Anxiety, Depression and Somatization. No differences were observed between the groups on the children's self-ratings, or in terms of numbers of children falling above the 90th percentile for both parent and child ratings. Secondary analyses did not produce any group differences between the chronic renal insufficiency and end-stage renal disease severity groupings. Conclusions: These findings failed to show the presence of social-behavioural difficulties in children with CKD, although there may be specific concerns for the presence of internalizing symptoms as per parent ratings. These findings suggest the need for follow-up of the subtle affective symptoms that might be present in children with CKD as recognizing these subthreshold social-behavioural symptoms may be a critical part of their overall clinical care.