School attendance and sport participation amongst children with chronic kidney disease: a cross-sectional analysis from the Kids with CKD (KCAD) study,Pediatric Nephrology

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School attendance and sport participation amongst children with chronic kidney disease: a cross-sectional analysis from the Kids with CKD (KCAD) study
Pediatric Nephrology ( IF 3 ) Pub Date : 2023-11-09 , DOI: 10.1007/s00467-023-06198-0
Adam C Hudson _{1,

2} , Anita van Zwieten _{1,

2} , Kylie-Ann Mallitt _{1,

2} , Anne Durkan _{1,

3} , Deirdre Hahn _{1,

3} , Chandana Guha _{1,

2} , Rabia Khalid _{1,

2} , Madeleine Didsbury _{1,

2} , Anna Francis _{1,

2,

4} , Steven McTaggart ₄ , Fiona E Mackie ₅ , Chanel Prestidge ₆ , Armando Teixeira-Pinto _{1,

2} , Suncica Lah ₇ , Martin Howell _{1,

2,

8} , Kirsten Howard _{2,

8} , Natasha Nassar ₉ , Allison Jaure _{1,

2} , Jonathan C Craig ₁₀ , Germaine Wong _{1,

2,

11} , Siah Kim _{1,

2}

Affiliation

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.
Department of Nephrology, The Children's Hospital at Westmead, Westmead, Australia.
Child & Adolescent Renal Service, Queensland Children's Hospital, Brisbane, Australia.
Department of Nephrology, Sydney Children's Hospital at Randwick, Sydney, Australia.
Department of Nephrology, Starship Children's Hospital, Auckland, New Zealand.
School of Psychology, The University of Sydney, Sydney, Australia.
Menzies Centre for Health Policy and Economics, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
Child Population and Translational Health Research, Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
College of Medicine and Public Health, Flinders University, Adelaide, Australia.
Centre for Transplant and Renal Research, Westmead Hospital, Sydney, Australia.

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.

Graphical abstract

中文翻译：

慢性肾病儿童的入学率和运动参与：慢性肾病儿童 (KCAD) 研究的横断面分析

背景

上学和生活参与，特别是运动，是患有慢性肾病 (CKD) 的儿童的首要任务。本研究旨在评估 CKD 儿童的 CKD 阶段、运动参与和缺课之间的关联。

方法

利用两国 CKD 儿童研究（年龄 6-18 岁，n = 377）的数据，我们进行了多变量回归来评估 CKD 阶段、缺课和运动参与之间的关联。

结果

总体而言，62% 的参与者参加体育运动，其中最频繁的体育活动是游泳 (17%) 和足球 (17%)。与 CKD 1-2 级儿童相比，CKD 3-5 级、透析或移植儿童参与运动的发生率比 (IRR) (95% CI) 分别为 0.84 (0.64-1.09)、0.59 (0.39-0.90) 、和 0.75 (0.58–0.96)。四个星期内缺课的中位天数 (IQR) 为 1 天 (0-1)，接受透析的儿童缺课次数最多（9 天 (5-15)），其次是移植接受者（ 2 天 (1–7))，CKD 3–5 儿童（1 天 (0–3)），以及 CKD 1–2 儿童（1 天 (0–3)）。CKD 持续时间改变了 CKD 阶段与缺课之间的关联，随着 CKD 持续时间的增加，接受移植的儿童缺课天数增多，但 CKD 1-5 或透析儿童则不然（p 交互作用< 0.01 ）。