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Hudson AC, van Zwieten A, Mallitt KA, Durkan A, Hahn D, Guha C, Khalid R, Didsbury M, Francis A, McTaggart S, Mackie FE, Prestidge C, Teixeira-Pinto A, Lah S, Howell M, Howard K, Nassar N, Jaure A, Craig JC, Wong G, Kim S. School attendance and sport participation amongst children with chronic kidney disease: a cross-sectional analysis from the Kids with CKD (KCAD) study. Pediatr Nephrol 2024; 39:1229-1237. [PMID: 37945915 PMCID: PMC10899305 DOI: 10.1007/s00467-023-06198-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 10/05/2023] [Accepted: 10/06/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND School attendance and life participation, particularly sport, is a high priority for children with chronic kidney disease (CKD). This study is aimed at assessing the association between CKD stage, sports participation, and school absences in children with CKD. METHODS Using data from the binational Kids with CKD study (ages 6-18 years, n = 377), we performed multivariable regression to evaluate the association between CKD stage, school absences, and sports participation. RESULTS Overall, 62% of participants played sport with the most frequent sport activities engaged in being swimming (17%) and soccer (17%). Compared to children with CKD 1-2, the incidence rate ratios (IRR) (95% CI) for sports participation amongst children with CKD 3-5, dialysis, or transplant were 0.84 (0.64-1.09), 0.59 (0.39-0.90), and 0.75 (0.58-0.96), respectively. The median (IQR) days of school absences within a four-week period were 1 day (0-1), with children on dialysis reporting the highest number of school absences (9 days (5-15)), followed by transplant recipients (2 days (1-7)), children with CKD 3-5 (1 day (0-3)), and with CKD 1-2 (1 day (0-3)). Duration of CKD modified the association between CKD stage and school absences, with children with a transplant experiencing a higher number of missed school days with increasing duration of CKD, but not in children with CKD 1-5 or on dialysis (p-interaction < 0.01). CONCLUSIONS Children receiving dialysis and with a kidney transplant had greater school absences and played fewer sports compared to children with CKD stages 1-2. Innovative strategies to improve school attendance and sport participation are needed to improve life participation of children with CKD.
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Affiliation(s)
- Adam C Hudson
- Centre for Kidney Research, The Children's Hospital at Westmead, Cnr Hainsworth St and Hawkesbury Road, Westmead, NSW, 2145, Australia
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
| | - Anita van Zwieten
- Centre for Kidney Research, The Children's Hospital at Westmead, Cnr Hainsworth St and Hawkesbury Road, Westmead, NSW, 2145, Australia
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
| | - Kylie-Ann Mallitt
- Centre for Kidney Research, The Children's Hospital at Westmead, Cnr Hainsworth St and Hawkesbury Road, Westmead, NSW, 2145, Australia
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
| | - Anne Durkan
- Centre for Kidney Research, The Children's Hospital at Westmead, Cnr Hainsworth St and Hawkesbury Road, Westmead, NSW, 2145, Australia
- Department of Nephrology, The Children's Hospital at Westmead, Westmead, Australia
| | - Deirdre Hahn
- Centre for Kidney Research, The Children's Hospital at Westmead, Cnr Hainsworth St and Hawkesbury Road, Westmead, NSW, 2145, Australia
- Department of Nephrology, The Children's Hospital at Westmead, Westmead, Australia
| | - Chandana Guha
- Centre for Kidney Research, The Children's Hospital at Westmead, Cnr Hainsworth St and Hawkesbury Road, Westmead, NSW, 2145, Australia
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
| | - Rabia Khalid
- Centre for Kidney Research, The Children's Hospital at Westmead, Cnr Hainsworth St and Hawkesbury Road, Westmead, NSW, 2145, Australia
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
| | - Madeleine Didsbury
- Centre for Kidney Research, The Children's Hospital at Westmead, Cnr Hainsworth St and Hawkesbury Road, Westmead, NSW, 2145, Australia
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
| | - Anna Francis
- Centre for Kidney Research, The Children's Hospital at Westmead, Cnr Hainsworth St and Hawkesbury Road, Westmead, NSW, 2145, Australia
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
- Child & Adolescent Renal Service, Queensland Children's Hospital, Brisbane, Australia
| | - Steven McTaggart
- Child & Adolescent Renal Service, Queensland Children's Hospital, Brisbane, Australia
| | - Fiona E Mackie
- Department of Nephrology, Sydney Children's Hospital at Randwick, Sydney, Australia
| | - Chanel Prestidge
- Department of Nephrology, Starship Children's Hospital, Auckland, New Zealand
| | - Armando Teixeira-Pinto
- Centre for Kidney Research, The Children's Hospital at Westmead, Cnr Hainsworth St and Hawkesbury Road, Westmead, NSW, 2145, Australia
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
| | - Suncica Lah
- School of Psychology, The University of Sydney, Sydney, Australia
| | - Martin Howell
- Centre for Kidney Research, The Children's Hospital at Westmead, Cnr Hainsworth St and Hawkesbury Road, Westmead, NSW, 2145, Australia
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
- Menzies Centre for Health Policy and Economics, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Kirsten Howard
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
- Menzies Centre for Health Policy and Economics, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Natasha Nassar
- Child Population and Translational Health Research, Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Allison Jaure
- Centre for Kidney Research, The Children's Hospital at Westmead, Cnr Hainsworth St and Hawkesbury Road, Westmead, NSW, 2145, Australia
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
| | - Jonathan C Craig
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Germaine Wong
- Centre for Kidney Research, The Children's Hospital at Westmead, Cnr Hainsworth St and Hawkesbury Road, Westmead, NSW, 2145, Australia
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
- Centre for Transplant and Renal Research, Westmead Hospital, Sydney, Australia
| | - Siah Kim
- Centre for Kidney Research, The Children's Hospital at Westmead, Cnr Hainsworth St and Hawkesbury Road, Westmead, NSW, 2145, Australia.
- Sydney School of Public Health, The University of Sydney, Sydney, Australia.
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Khalid R, Van Zwieten A, Kim S, Didsbury M, Francis A, Mctaggart S, Walker A, Mackie FE, Prestidge C, Teixeira-Pinto A, Barton B, Lorenzo J, Lah S, Howard K, Nassar N, Au E, Tong A, Blazek K, Craig JC, Wong G. Association between socioeconomic status and academic performance in children and adolescents with chronic kidney disease. Pediatr Nephrol 2022; 37:3195-3204. [PMID: 35355084 PMCID: PMC9587100 DOI: 10.1007/s00467-022-05515-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 02/20/2022] [Accepted: 02/22/2022] [Indexed: 01/10/2023]
Abstract
BACKGROUND Lower socioeconomic status (SES) is associated with lower academic achievement; however, this relationship is understudied in children with chronic kidney disease (CKD). This study examined the relationship between SES and academic performance in children and adolescents with CKD. METHODS A total of 377 participants aged 6-18 years with CKD stages 1-5 (n = 199), on dialysis (n = 43) or with a kidney transplant (n = 135) were recruited. Five SES measures and a composite SES index were examined for associations with parent-rated average or above average academic performance in numeracy and literacy using multivariable logistic regression. RESULTS Participants' median age was 12.6 years (IQR 8.9-15.5). Adjusted odds ratios (aOR) (95%CI) for better performance in numeracy and literacy, respectively, were 0.71 (0.44-1.15) and 0.75 (0.45-1.23) for children whose caregivers had lower educational attainment; 0.46 (0.26-0.80) and 0.53 (0.30-0.93) for lower household income; 0.52 (0.32-0.85) and 0.44 (0.26-0.73) for caregivers who were unemployed; 0.68 (0.41-1.12) and 0.59 (0.35-1.00) for caregivers with poor self-rated financial status; and 0.93 (0.53-1.64) and 1.00 (0.56-1.79) for caregivers who did not own their own home. Compared with the highest SES index quartile, the aORs for better performance by SES quartile in descending order were 1.24 (0.60-2.54), 0.76 (0.37-1.58), and 0.39 (0.18-0.86) for numeracy and 0.88 (0.41-1.85), 0.77 (0.35-1.66), and 0.32 (0.14-0.72) for literacy. No interactions were identified between SES and CKD stage, child age, or gender. CONCLUSIONS Across all CKD stages, children from lower SES families are less likely to perform well in literacy and numeracy than those from higher SES households. A higher resolution version of the Graphical abstract is available as Supplementary information.
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Affiliation(s)
- Rabia Khalid
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, Australia.
- Sydney School of Public Health, The University of Sydney, Sydney, Australia.
| | - Anita Van Zwieten
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, Australia
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
| | - Siah Kim
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, Australia
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
| | - Madeleine Didsbury
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, Australia
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
| | - Anna Francis
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, Australia
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
- Child & Adolescent Renal Service, Queensland Children's Hospital, Brisbane, Australia
| | - Steven Mctaggart
- Child & Adolescent Renal Service, Queensland Children's Hospital, Brisbane, Australia
| | - Amanda Walker
- Department of Nephrology, The Royal Children's Hospital, Melbourne, Australia
| | - Fiona E Mackie
- Department of Nephrology, Sydney Children's Hospital at Randwick, Sydney, Australia
| | - Chanel Prestidge
- Department of Nephrology, Starship Children's Hospital, Auckland, New Zealand
| | - Armando Teixeira-Pinto
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, Australia
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
| | - Belinda Barton
- Children's Hospital Education Research Institute, The Children's Hospital at Westmead, Sydney, Australia
| | - Jennifer Lorenzo
- Kids Neuroscience Centre, The Children's Hospital at Westmead, Sydney, Australia
| | - Suncica Lah
- School of Psychology, The University of Sydney, Sydney, Australia
| | - Kirsten Howard
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
- Menzies Centre for Health Policy and Economics, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Natasha Nassar
- Child Population and Translational Health Research, Children's Hospital at Westmead Clinical School, The University of Sydney, Sydney, Australia
| | - Eric Au
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, Australia
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
| | - Allison Tong
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, Australia
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
| | - Katrina Blazek
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, Australia
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
| | - Jonathan C Craig
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, Australia
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Germaine Wong
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, Australia
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
- Centre for Transplant and Renal Research, Westmead Hospital, Sydney, Australia
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