Quality of life in children with kidney transplant: Systematic review

To identify in the literature studies that evaluate the quality of life in pediatric patients with kidney transplant through use of specific, validated instruments in Pediatrics.

Method:

Systematic review of the literature with searches conducted in the following databases: Medline, PubMed, LILACS, CINAHL, SciELO and Cochrane Library. Main keywords: Quality of life, Kidney transplantation and Pediatrics.

Results:

A total of 366 studies were selected and eight observational studies were included that evaluated the quality of life of children with kidney transplant by means of evaluation instruments of quality of life.

Conclusion:

The quality of life of children with kidney transplant is inferior compared to healthy children. The post-transplant period presents better results compared to pre-transplant children. The identification of mental, physical and social conditions related to the quality of life of this population allows for better planning the assistance provided to them.

Descriptors:
Quality of Life; Kidney Transplantation; Pediatrics; Nursing; Review

Publication, year and country	Type of study	No. of participants/Age group	QOL instrument^†† †† Quality of life	Type of monitoring	Result	Level of evidence
Park Ki-Soo, et al, South Korea, 2012⁽⁷7 KS Park, IS Ha, HG Kang, HI Cheong, YS Park, YJ Lee, et al. Quality of life in children with end-stage renal disease based on a PedsQL ESRD module. Pediatr Nephrol[Internet]. 2012[cited 2017 Aug 1];27(12):2293-300. Available from: https://link.springer.com/article/10.1007%2Fs00467-012-2262-1 https://link.springer.com/article/10.100... ⁾	ObservationalCross-sectional	92/2-18 years	PedsQL 3.0 ESRD module	Outpatient	Transplant patients presented better QOL compared to under dialysis treatment. There was no difference in total QOL scores between PD^* * Peritoneal Dialysis; and KTx^ Kidney transplant; according to the children's report.	III
Bamford J, et al, United Kingdom, 2016⁽⁸8 Bamford J, Wirz L. Piloting psychology annual reviews as a method of measuring psychological distress and quality of life in paediatric renal transplant patients. BioMed Res Int[Internet]. 2016[cited 2017 Aug 10].id1685362 Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5124635/pdf/BMRI2016-1685362.pdf https://www.ncbi.nlm.nih.gov/pmc/article... ⁾	Observational Cohort Study	31/3-18 years	PedsQL 4.0	Outpatient	The biggest concerns regarding transplantation for children and adolescents are: physical appearance, physical discomfort, pain, and damaged social relations.	III
Oborn H., et al, 2016, Sweden⁽¹¹11 Oborn H, Wettergren L, Herthelius M, Forinder U. Associations between lower urinary tract dysfunction and health-related quality of life in children with chronic kidney disease. Acta Paediatr[Internet]. 2016[cited 2017 Sep 13];105(8):959-66. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5089597/pdf/APA-105-959.pdf https://www.ncbi.nlm.nih.gov/pmc/article... ⁾	Observational Cross-sectional	59/8-18 years	DISABKIDS37KIDSCREEN-27	Outpatient	There was no difference in QOL when comparing populations with kidney transplant and pediatric population in general.	III
Yadav P, et al, 2017, Indi^a(¹²12 Yadav P, Nunia S, Bansal A, Sureka SK, Jena R, Ansari MS, et al. Mutidimensional assessment of Quality of Life of Children and problem of parents in India Society after pediatric renal transplant: beyond the conventional thoughts. Pediatr Transplant[Internet]. 2017[cited 2017 Sep 13];21(6):e13001. Available from: https://onlinelibrary.wiley.com/doi/abs/10.1111/petr.13001 https://onlinelibrary.wiley.com/doi/abs/... ⁾	ObservationalCross-sectional	62/ < 18 years	WHOQOL-BREF	Outpatient	KTx^ Kidney transplant; had beneficial effect in all areas assessed.	III
Anthony et al, 2010, Canada⁽¹³13 Anthony SJ, Hebert D, Todd L, Korus M, Langlois V, Pool R, et al. Child and parental perspectives of multidimensional quality of life outcomes after kidney transplantation. Pediatric Transplant[Internet]. 2010[cited 2017 Sep 13];14(2):249-56. Available from: https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1399-3046.2009.01214.x https://onlinelibrary.wiley.com/doi/abs/... ⁾	Observational Cross-sectional	23/2-18 years	VAQOL and General Health/ PedsQL	Outpatient	Compromised areas were: physical appearance, symptoms, difficulty in family interaction and school disruption.	III
Buyan N, et al, 2010, Turkey ⁽¹⁴14 Buyan N, Türkmen MA, Bilge I, Baskin E, Haberal M, Bilginer Y, et al. Quality of life in children with chronic kidney disease (with child and parent assessments). Pediatr Nephrol[Internet]. 2010[cited 2017 Sep 13];25(8):1487-96. Available from: https://dx.doi.org/10.1007/s00467-010-1486-1 https://dx.doi.org/10.1007/s00467-010-14... ⁾	ObservationalCase-control	211 /4-18 years	KINDL^®	Hospital	The analysis of patients with ESKD^† † End-stage kidney disease; (PD^* * Peritoneal Dialysis; + KxT^ Kidney transplant; ) showed lower scores on all subscales compared to the control group, except for physical well-being.	III
Dotis J, et al, 2016, Greece⁽¹⁵15 Dotis J, Pavlaki A, Printza N, Stabouli S, Antoniou S, Gkogka C, et al. Quality of life in children with chronic kidney disease. Pediatr Nephrol[Internet]. 2016[cited 2017 Sep 13];31(12):2309-16. Available from: https://link.springer.com/article/10.1007/s00467-016-3457-7 https://link.springer.com/article/10.100... ⁾	ObservationalCase-control	55/8 to 18 years	KIDSCREEN-52	Outpatient	Children with ESKD^† † End-stage kidney disease; presented scores of physical well-being lower than healthy children.	III
Diseth TH, et al, 2010, Norway⁽¹⁶16 Diseth TH, Tangeraas T, Reinfjell T, Bjerre A. Kidney transplantation in childhood: mental health and quality of life of children and caregivers. Pediatr Nephrol[Internet]. 2011[cited 2014 Mar];26(10):1881-92. Available from: https://link.springer.com/article/10.1007/s00467-011-1887-9 https://link.springer.com/article/10.100... ⁾	Observational Case-control	38/2 to 19 years	SDQ, PedsQL, GHQ	Hospital	Children with kidney transplant and parents had significantly lower QOL^†† †† Quality of life scores in all areas, except for emotional functioning.	III

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[1] CORRESPONDING AUTHOR Monica Taminato E-mail: mtaminato@unifesp.br