283 - An Examination of Anxiety, Depression, and Quality of Life of Pediatric Patients on a Pediatric Hemodialysis Unit

Poster Number: 283
Publication Number: 283.252

Eyad Ali, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Carisa Parrish, Children's Mercy Kansas City, Kansas City, MO, United States; Robert J. Berg, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Paige L. Seegan, Johns Hopkins University School of Medicine, Baltimore, MD, United States

Background: Pediatric patients with end-stage renal disease (ESRD) in need of hemodialysis (HD) are at higher risk for lower quality of life compared to youth without a chronic health condition. Demanding treatment regimens can impact the physical, cognitive, and social/emotional wellbeing of pediatric patients. However, limited research has examined psychosocial measures in pediatric patients receiving HD treatment.

Objective: This study builds on a prior examination of the association between depression symptoms and health-related quality of life (HRQOL) in pediatric patients located in a major hospital in an urban setting with an expanded dataset and an additional measure of anxiety.

Design/Methods: Participants included were 17 patients ages 12 to 21 years; 53% were male, 18% were White, 6% were Hispanic/Latino, 6% Asian, 65% were Black/African American, and 6% other. As part of standard clinical procedures, patients complete three psychosocial measures to monitor adjustment in the HD unit at monthly intervals, with the first time point occurring when patients first admit to the unit. The PedsQL ESRD Module self-report measure consisting of seven scales assessed HRQOL. The Patient Health Questionnaire-2 (PHQ-2) screened for depressed mood and anhedonia. The Generalized Anxiety Disorder-7 (GAD-7) assessed severity of generalized anxiety symptoms. Data were extracted from Jan 2019-Nov 2022, with completed time points ranging from 3-43 (M=19.53). Pearson correlations were used to determine associations between participants’ average PedsQL total score and PHQ-2/GAD-7 total scores across time points.

Results: Average PHQ-2 scores were significantly correlated with HRQOL (r=-.75; p< 0.001), indicating higher symptoms of depression were associated with lower HRQOL. Similarly, average GAD-7 scores were significantly correlated with HRQOL (r=-.75; p< .01). Similar associations were found between depression and anxiety on all subdomains of HRQOL-ESRD except for treatment problems (p=.13, p=.46) and communication problems (p=.24, p=.28), respectively. Correlation analyses across time points indicated similar negative associations between PHQ-2, GAD-7, and HRQOL total scores, as well as various PedsQL ESRD subdomain scores.

Conclusion(s): Results highlight the importance of routine psychological screenings of pediatric patients on HD to ensure early identification and appropriate treatment referrals are offered. Although expected for this population, the small sample size suggests further examination among larger samples is necessary to draw any meaningful conclusions.