Gaining the Patient Reported Outcomes Measurement Information System (PROMIS) perspective in chronic kidney disease: a Midwest Pediatric Nephrology Consortium study

David T. Selewski, Susan F. Massengill, Jonathan P. Troost, Larysa Wickman, Kassandra L. Messer, Emily Herreshoff, Corinna Bowers, Maria E. Ferris, John D. Mahan, Larry A. Greenbaum, Jackie MacHardy, Gaurav Kapur, Deepa H. Chand, Jens Goebel, Gina Marie Barletta, Denis Geary, David B. Kershaw, Cynthia G. Pan, Rasheed Gbadegesin, Guillermo HidalgoJerome C. Lane, Jeffrey D. Leiser, Peter X. Song, David Thissen, Yang Liu, Heather E. Gross, Darren A. DeWalt, Debbie S. Gipson

Research output: Contribution to journalArticle

20 Scopus citations

Abstract

Background and objectives: Chronic kidney disease is a persistent chronic health condition commonly seen in pediatric nephrology programs. Our study aims to evaluate the sensitivity of the Patient Reported Outcomes Measurement Information System (PROMIS) pediatric instrument to indicators of disease severity and activity in pediatric chronic kidney disease.

Methods: This cross sectional study included 233 children 8–17 years old, with chronic kidney disease from 16 participating institutions in North America. Disease activity indicators, including hospitalization in the previous 6 months, edema, and number of medications consumed daily, as well as disease severity indicators of kidney function and coexisting medical conditions were captured. PROMIS domains, including depression, anxiety, social-peer relationships, pain interference, fatigue, mobility, and upper extremity function, were administered via web-based questionnaires. Absolute effect sizes (AES) were generated to demonstrate the impact of disease on domain scores. Four children were excluded because of missing glomerular filtration rate (GFR) estimations.

Results: Of the 229 children included in the final analysis, 221 completed the entire PROMIS questionnaire. Unadjusted PROMIS domains were responsive to chronic kidney disease activity indicators and number of coexisting conditions. PROMIS domain scores were worse in the presence of recent hospitalizations (depression AES 0.33, anxiety AES 0.42, pain interference AES 0.46, fatigue AES 0.50, mobility AES 0.49), edema (depression AES 0.50, anxiety AES 0.60, pain interference AES 0.77, mobility AES 0.54) and coexisting medical conditions (social peer-relationships AES 0.66, fatigue AES 0.83, mobility AES 0.60, upper extremity function AES 0.48).

Conclusions: The PROMIS pediatric domains of depression, anxiety, social-peer relationships, pain interference, and mobility were sensitive to the clinical status of children with chronic kidney disease in this multi-center cross sectional study. We demonstrated that a number of important clinical characteristics including recent history of hospitalization and edema, affected patient perceptions of depression, anxiety, pain interference, fatigue and mobility. The PROMIS instruments provide a potentially valuable tool to study the impact of chronic kidney disease. Additional studies will be required to assess responsiveness in PROMIS score with changes in disease status over time.

Original languageEnglish
Pages (from-to)2347-2356
Number of pages10
JournalPediatric Nephrology
Volume29
Issue number12
DOIs
StatePublished - Jan 1 2014
Externally publishedYes

Keywords

  • Children
  • Chronic kidney disease
  • End stage kidney disease
  • Patient reported outcomes
  • Pediatrics
  • Quality of life
  • Transplant

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    Selewski, D. T., Massengill, S. F., Troost, J. P., Wickman, L., Messer, K. L., Herreshoff, E., Bowers, C., Ferris, M. E., Mahan, J. D., Greenbaum, L. A., MacHardy, J., Kapur, G., Chand, D. H., Goebel, J., Barletta, G. M., Geary, D., Kershaw, D. B., Pan, C. G., Gbadegesin, R., ... Gipson, D. S. (2014). Gaining the Patient Reported Outcomes Measurement Information System (PROMIS) perspective in chronic kidney disease: a Midwest Pediatric Nephrology Consortium study. Pediatric Nephrology, 29(12), 2347-2356. https://doi.org/10.1007/s00467-014-2858-8