Physical Fitness in Children With End-Stage Renal Disease

Department of Pediatrics, Baylor College of Medicine, Renal Dialysis Unit and Pheresis Service, Texas Children's Hospital, Houston, TX 77030, USA.
Advances in chronic kidney disease (Impact Factor: 2.05). 11/2009; 16(6):430-6. DOI: 10.1053/j.ackd.2009.08.011
Source: PubMed


Medical advances have allowed the majority of children with ESRD to survive into adulthood. As a result, more attention is being focused on improving the health-related quality of life (HRQOL) for children with ESRD. However, most pediatric ESRD HRQOL studies have highlighted on the psychosocial effects of ESRD, with less attention paid to the physical effects. A few studies have recently measured exercise capacity in children with ESRD in the last 5 years. This article reviews studies that detail the physical components of HRQOL as well as other studies that have started to document the exercise capacity of children with ESRD.

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    • "Most HRQOL studies on CKD children and adolescents have highlighted the psychosocial effects with less attention paid to its relation to physical effects [58]. In our study we revealed that the health status variables BMI, height and CR Fitness correlated and even predicted mental health problems, psychosocial dysfunction and poor QOL. "
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    ABSTRACT: Our objective was to assess the mental health and health-related quality of life (HRQOL) in children and their parents after renal transplantation (TX) compared to healthy controls and children with acute lymphoblastic leukemia (ALL) and to identify possible health status variables associated with impaired mental health and HRQOL. Thirty-eight TX children with a median age of 13 (range 3-19) years were investigated. Mental health was assessed by the Pediatric Quality of Life Inventory (PedsQL) 4.0 Generic Core Scales and the Strength and Difficulties Questionnaire (SDQ-20). Each mother's own mental health and QOL were assessed by the General Health Questionnaire (GHQ-30) and the Quality of Life Scale (QOLS). Forty children with ALL [median age 11 (8.5-15.4) years] and 42 healthy children [median age 11 (8.9- 15) years] served as controls. Treadmill exercise results from 22 of the 38 patients were included in the analysis. TX children showed significantly higher levels of mental health problems and lower HRQOL at 2 to 16 years after transplantation compared to both control groups. Body mass index and maximal oxygen uptake (nā€‰=ā€‰22/38) were significant predictors of child mental health (SDQ) and child QOL (PedsQL), respectively. Based on these results, we suggest that rehabilitation after TX should include a focus on physical activity and QOL to reduce interconnected physical and psychological morbidity in kidney TX children.
    Pediatric Nephrology 04/2011; 26(10):1881-92. DOI:10.1007/s00467-011-1887-9 · 2.86 Impact Factor
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    ABSTRACT: It is well known that adults suffering from chronic kidney disease (CKD) experience muscle wasting and excessive fatigue, which results in a reduced exercise capacity and muscle weakness compared to their healthy counterparts, but research suggests that this can be improved through exercise. There is very limited data available regarding exercise tolerance in children with CKD and even less on the effects of exercise training programs. However, the available evidence does suggest that like adults, children also suffer from poor exercise capacity and reduced muscle strength, although the reasons for these limitations remain unclear. Studies that have attempted to implement exercise training programs in pediatric CKD populations have experienced high dropout rates, suggesting that the approach used to implement such programs in children needs to be different from the approach used for adults. This review summarizes the current knowledge regarding exercise capacity and muscle strength in children with CKD, the methods used to perform these assessments, and the possible causes of physical limitations. The results of exercise training studies, and the potential reasons as to why training programs have proved relatively unsuccessful are also discussed.
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