ArticlePediatric nephrology (Berlin, Germany)2026
Health-related quality of life in children with chronic kidney disease: clinical predictors and ROC-derived thresholds for impaired HRQoL.
Article in Pediatric nephrology (Berlin, Germany), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundChronic kidney disease (CKD) in childhood is associated with multidimensional disease burden extending beyond physiological impairment. While reduced health-related quality of life (HRQoL) has been consistently reported, the clinical interpretability and stratification value of HRQoL measures in pediatric CKD remain insufficiently characterized.
methodsIn this cross-sectional study, HRQoL was assessed using the Pediatric Quality of Life Inventory (PedsQL) in 47 children with CKD and 46 healthy controls. Group differences were analyzed across domains and total scores. Receiver operating characteristic (ROC) analysis was performed to derive a clinically interpretable cutoff value of PedsQL total score for identifying poor HRQoL. Logistic regression models examined associations between renal function parameters and poor HRQoL within the CKD cohort. A within-CKD risk stratification model incorporating eGFR and blood urea nitrogen (BUN) was constructed.
resultsChildren with CKD demonstrated significantly lower HRQoL across physical, emotional, school, psychosocial, and total domains compared with controls (all p < 0.001). ROC analysis was performed to derive a clinically interpretable threshold for impaired HRQoL based on the PedsQL total score, yielding an optimal cutoff value of ≤ 85.8 (AUC 0.826; 95% CI 0.734-0.907) with 70.2% sensitivity and 89.1% specificity. Within the CKD cohort, lower eGFR and higher BUN remained independently associated with poor HRQoL in multivariable analysis. The within-CKD risk model incorporating eGFR and BUN demonstrated moderate discriminatory performance (AUC 0.728) for identifying high-burden patients.
conclusionsChildren with CKD experience clinically meaningful HRQoL impairment, particularly in advanced disease stages. Objective renal function parameters not only correlate with but moderately discriminate high-burden patients within the CKD population. Integration of structured HRQoL assessment into routine pediatric nephrology care may enhance patient-centered risk stratification.
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