SAT-237 PSYCHOPATHOLOGY AND PSYCHOSOCIAL ADJUSTMENT IN PEDIATRIC CHRONIC KIDNEY DISEASE: RESULTS FROM THE KNOW-Ped CKD

Abstract

Chronic kidney disease (CKD) requires management in daily life; accordingly, psychosocial development of pediatric patients with CKD is greatly affected due to delayed growth, frequent absences from school, and difficulties engaging in normal activities of peer relationships due to CKD. This study was to investigate the mental health problems of children and adolescent with CKD in KoreaN cohort study for Outcome in patients with Pediatric Chronic Kidney Disease (KNOW-Ped CKD). In KNOW-PedCKD, 437 children with stage 1 to 5 of CKD were enrolled. We evaluated 167 CKD patients aged from 6-18 years (mean age, 10.6±3.9 years, male, 117 (70.1%)). Demographic data and clinical history were collected. And the parents of subject completed the Korean-Child Behavioral Checklist (K-CBCL). We compared the clinical characteristics according to the clinical group defined as one or more abnormal finding in the subscale of K-CBCL. Of the total patients, 13.2% of children had a clinically significant internalizing problem such as depression, anxiety and somatic symptoms and 9.0% of children had an externalizing problem such as rule breaking or aggressive behavior. The distribution of clinical group was 33.5% in our cohort. In the clinical group, height Z score and weight Z score were lower, and growth hormone was more used than the non-clinical group. Developmental delay and preterm birth history were more common in the clinical group. Logistic regression analysis revealed that the growth retardation and history of developmental delay was significantly correlated with the clinical group in terms of psychopathology and adjustment problem. Significant proportions of children and adolescents with CKD suffer from mental health problem and adjustment problem. Combined physical illness and growth retardation associated with CKD may be more important than CKD stage, etiology, and the complications associated with the progression of CKD in terms of mental health.