The effects of chronic kidney disease on quality of life in children and adolescents

Chronic disease can impair physical and cognitive function of individuals and lead to a decrease in the quality of life and disability. Decades ago, when treatment options to support children with chronic kidney disease were limited, before forms of renal replacement therapy including organ transplantation were available, the prognosis of advanced renal disease was grave. Even though the mortality rate remains high, the long-term survival rate for children has improved dramatically due to medical care advances. As the outcome continues to improve, a solid interest in disease and treatment associated morbidities and quality of life including psychosocial consequences has developed. The effect of treatment and disease related changes in child's quality of life, including disability, remain significant but might improve as we learn to understand better the involved factors. The effects on quality of life and perception of the degree of disability vary significantly, depending on the stage of kidney disease, age of the child, and support system. Quality of life, including disability, can be divided into three major domains: physical, cognitive, and psychosocial, with a variety of important sub domains that have to be assessed individually. Overall, very little data are available with regard to the perception of disability by the affected patients and their caregivers. This article tries to review comprehensively the etiologic factors of renal disease in children with the associated medical implications. The goal is to provide an overview of changes in quality of life that are related to the various stages of advanced renal disease in children and adolescents.