A research led by Johns Hopkins Children's Center has revealed that even slight kidney disease can hamper a child's quality of life negatively.
The new finding counters prevailing wisdom that only children with end-stage kidney disease suffer physical, social, emotional and educational setbacks.
The study suggested that earlier attention to quality-of-life issues in children with chronic kidney disease is needed.
"Even mild and moderate declines in kidney function may lead to serious physical, emotional, intellectual and social challenges. What this means is we should be thinking about screening children for these challenges and intervening earlier than we once thought," said lead investigator Dr. Arlene Gerson, a pediatric psychologist at Hopkins Children's.
For example, recently diagnosed children who report learning problems may benefit from help before grades drop, said researchers.
They noted that children with chronic diseases currently do not qualify for special education until their scores decline dramatically.
In their study of 402 children, ages 2 to 16, with mild-to-moderate kidney disease, researchers analysed the link between kidney function, disease severity, age of onset and disease duration, on the one hand, and physical, emotional, psychological and school functioning on the other.
The researchers also compared quality-of-life outcomes between healthy children and children with early-stage kidney disease.
Children with mild-to-moderate kidney disease and their parents reported worse overall outcomes on standard quality-of-life questionnaires and worse outcomes on all quality-of-life factors.
Specifically, children with early-stage kidney disease scored on average 75 out of 100 on quality-of-life measures, compared to 83 out of 100 for healthy children.
The difference was especially pronounced in school functioning, where children with early-stage kidney disease scored 64 out 100, compared to 80 out of 100 for healthy children.
The study also found that the younger the child at the time of the diagnosis and the longer the child lived with kidney disease, the better the overall quality of life, said the researchers.
They suggested that as time passes children learn to cope better with their condition.
The researchers found that children with impaired growth and shorter stature, a common effect of their disease, had worse overall quality of life and poorer physical functioning, an indicator of the importance of early treatment.
"Timely and individually tailored treatment, be it with nutrition, salt supplements or growth hormones, if needed, can make a big difference. We cannot overemphasize the importance of early intervention in children with early stages of chronic kidney disease," said senior investigator Dr. Susan Furth.
The study was reported in the latest issue of Pediatrics.