Life participation in children with CKD: Impact on school attendance, social interests and sport participation

Abstract

Background: Children with Chronic Kidney Disease (CKD) face greater barriers in life compared to their peers. Living with CKD impacts on various life domains, including school, social participation, and sporting involvement. Our study aimed to quantify the impact of CKD on a child's school attendance, sport participation and social activities. We also investigated the impact of stage of CKD on these domains of life participation. Methods: This cross-sectional study used data from the kids with CKD study, which recruited children from five paediatric nephrology units across Australia and New Zealand. Participants aged 6-18 years old with CKD were recruited between 2013 and 2016. Data on school attendance, social activities and sport participation was obtained from patient and parent questionnaires. The relationship between CKD stage was investigated using Poisson regression. Results: The median number of days children with CKD missed in the preceding four weeks of school was two days (IQR: 0-6). Children on dialysis missed 4 fold higher days of school and children with a kidney transplant missed 2 fold higher days of school compared to children with CKD stages 1-2. The top 5 sports children with CKD participate in are swimming (17%), soccer (17%), football/rugby (12%), dance (9%), and basketball (8%). The median number of sports played by children with CKD was one (IQR: 0-2). Compared to children with CKD stages 1-2, children on dialysis played 47% (95% CI: 21%-65%) fewer sports and children with a kidney transplant played 23% (95% CI: 2 %-39%) fewer sports. Conclusion: Children with CKD play similar sports to their peers but children receiving kidney replacement therapy played fewer sports compared to children with CKD stages 1-2. Strategies are needed to improve school attendance and sport participation among children with CKD.