Recommendations of Polish Society Paediatric Nephrology for the management of the child with nephrotic syndrome

Polskie Towarzystwo Nefrologii Dziecięcej opracowało pierwsze zalecenia dotyczące postępowania z dzieckiem z zespołem nerczycowym. Wytyczne, przygotowane przez doświadczonych nefrologów dziecięcych z różnych polskich ośrodków specjalistycznych, powstały na podstawie dostępnych zaleceń europejskich oraz amerykańskich oraz wyników badań i metaanaliz o wysokim stopniu wiarygodności. Wytyczne nie powinny być odczytane jako nakaz postępowania. Ich celem jest wsparcie dla lekarzy zajmujących się dziećmi z chorobami nerek w ich wyborze najlepszej dla danego dziecka opcji diagnostycznej oraz terapeutycznej. Zalecenia będą w najbliższych latach regularnie aktualizowane, aby przybliżyć lekarzom informacje wynikające z postępu dokonującego się w dziedzinie glomerulopatii.The Polish Society for Paediatric Nephrology has prepared the society’s first recommendations on the management of the child with a nephrotic syndrome. The recommendations have been put together by a representative group of experienced pediatric nephrologists. They are based on existing European and American guidelines and the results of reliable published trials and meta-analyses. Their aim is to aid the physician in their independent choice of the best strategy available for the diagnosis and treatment of an individual child with NS. Due to the rapid progress in the field of glomerulonephritis the recommendations will be regularly updated by the Society in the coming years

Disease-related social situation in family of children with chronic kidney disease - parents' assessment : a multicentre study

Introduction and Objective. Chronic kidney disease (CKD) in children burdens life of patients and their families. Little is known about parents` assessment of families’ social situation. However, the knowledge of the details of a patient’s and his family’s life standards might influence modification and optimization of applied therapy. Therefore, the main goal of the present study was to explore the selected elements of life situation of patients suffering with CKD as well as their parents, depending on the CKD stage and appropriate treatment. Materials and Methods. Cross-sectional national study was conducted. A total of 203 children with CKD and 388 their parent-proxies (196 women and 192 men) were enrolled into this study. Patient data and questionnaires filled by both parents, concerning social-demographic parameters and assessment of changes in families after CKD diagnosis in the child, were analysed. Results. CKD children are being brought up in proper families whose financial situation is not good. Children need help in process of education. Perception of current situation differed between both parents in the change of the income source, taking care of CKD child, change in social relations and evaluating relations with medical staff. Parents do not obtain proper support from social workers. Conclusion. Families of CKD children require support in area of financial and educational help for school children. The discrepancies in evaluation of family situation between mothers and fathers of ill children might be the source of conflicts possibly resulting in worsening the outcome for CKD children

Anxiety in children and adolescents with chronic kidney disease - multicenter national study results

Background/Aims: Chronic medical illness is a significant risk factor for the development of psychiatric disorders. The aims of the study were: to investigate the level of anxiety in children with chronic kidney disease (CKD) and to identify factors associated with the presence of that emotional problem. Methods: CKD children on hemodialysis (HD, n=22), peritoneal dialysis (PD, n=20,) and on conservative treatment (CT, n=95) were enrolled in the study. We used State-Trait Anxiety Inventory (STAI) for adolescents and STAI-C for children. Socio-demographic and physical factors were assessed. Results: There was a significantly higher level of anxiety-state among HD children (8-12 years) compared with other groups of participants of the same age and Polish population norms. The level of anxiety among adolescents (13-18 years), both anxiety-state and anxiety-trait, was significantly higher in the HD group compared with other groups, which did not differ among themselves. In the HD adolescents, there was a correlation between the anxiety-state and the duration of the disease as well as with the number of hospitalizations. PD adolescents in the mainstream education had higher levels of anxiety-state and anxiety-trait compared with home schooled patients. Conclusions: Even though children and adolescents with CKD are at risk of developing a variety of emotional disorders, the level of anxiety among the researched group, with the exception of HD patients, was not significantly different than the level of anxiety among healthy subjects. Adolescents on HD who present a high level of anxiety should undergo long-term psychological treatment

Perception of health-related quality of life in children with chronic kidney disease by the patients and their caregivers : multicentre national study results

Objective The aim of the study was to analyse the healthrelated quality of life (HRQoL) in Polish children with chronic kidney disease (CKD) dependant on the CKD stage, treatment modality and selected social life elements in families of the patients. Furthermore, potential differences between self-report and parent/proxy reports and the factors influencing them were assessed. Methods A total of 203 CKD children (on haemodialysis (HD), peritoneal dialysis (PD) and conservative treatment (CT)) and their 388 parent/proxies were enrolled into a cross-sectional national study. The demographic and social data were evaluated. We used the Paediatric Quality of Life Inventory 4.0 Generic Core Scales to assess the HRQoL in children. Results Health-related quality of life scores for all CKD groups were significantly lower in all domains compared with population norms, the lowest one being in the HD group. In CT children, HRQoL did not depend on the CKD stage. Both parents assessed the HRQoL of their children differently depending on their involvement in the care. There are differences between the HRQoL scores of the children and their parents