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

Pediatr Nephrol 2014 Dec 9;29(12):2347-56. Epub 2014 Jun 9.

Division of Nephrology, Department of Pediatrics and Communicable Diseases, C.S. Mott Children's Hospital, University of Michigan, 1500 E Medical Center Drive, SPC5297, Ann Arbor, MI, 48109-5297, USA,

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.

Download full-text PDF

Source Listing
December 2014
91 Reads

Publication Analysis

Top Keywords

chronic kidney
kidney disease
pain interference
mobility aes
depression anxiety
anxiety aes
depression aes
disease activity
fatigue aes
disease severity
cross sectional
sectional study
aes 050
interference aes
medical conditions
interference fatigue
relationships pain


(Supplied by CrossRef)

ME Ferris et al.
Pediatr Nephrol 2006

SL Goldstein et al.
Pediatr Nephrol 2006

SL Goldstein et al.
Am J Kidney Dis 2008

SL Goldstein et al.
Pediatr Nephrol 2009

AM McKenna et al.
Nephrol Dial Transplant 2006

I Riano-Galan et al.
Pediatr Nephrol 2009

AC Gerson et al.
Pediatrics 2010

DE Irwin et al.
Qual Life Res 2010

KB Yeatts et al.
J Asthma 2010

JW Varni et al.
J Pain 2010

DE Irwin et al.
Qual Life Res 2011

Similar Publications