Introduction: Limited data exists about the epidemiology of kidneydisease in sub-Saharan East African children or impact of chronickidney disease (CKD) on health-related quality of life (HRQoL). Ourobjective was to describe types of renal disease, compare HRQoL inUgandan children with CKD and children with benign or resolvingrenal disease (non-CKD), and assess for predictors of HRQoL.Methods: This cross-sectional study of children aged 0-18 yearsassessed demographic, socioeconomic and clinical data and surveyedHRQoL using the Pediatric Quality of Life Core Scale TM (PedsQL)(scoring scale 0-100) for 4 domains (physical, emotional, social andschool) and overall HRQoL. CKD and non-CKD participant scores werecompared using unpaired t-test. Predictors of HRQoL were evaluatedusing linear and logistic regression analyses.Results: A total of 149 children were enrolled (71 in CKD group; 78 innon-CKD group; median age 9 years; male 63%). Primary renal dis-eases included nephrotic syndrome 83 (56%), glomerulonephritis 25(17%), obstructive uropathy 22 (15%), cystic kidney disease 6(3.7%), acute kidney injury 2 (1.3%), hypertension 2 (1.3%), humanimmunodeficiency virus-associated nephropathy 1 (0.7%), and un-known renal disease 8 (5%). Congenital anomalies of the kidney andurinary tract (CAKUT) accounted for 39% (28/71) of CKD etiologies.In the CKD group, 46% were at stage 5 with 10%, 14%, 16%, and14% at stages 4, 3, 2 and 1, respectively. Among school-eligiblechildren, 34% (19/56) with CKD did not attend school whereas allnon-CKD did (p<0.0001); CKD children enrolled in school missed onaverage 14 days per month. CKD children had significantly lowerHRQoL domain scores. Mean overall HRQoL score by child report was57 for CKD vs. 86 for non-CKD (p<0.0001), similar to caregiver report63 for CKD vs. 86 for non-CKD (p<0.0001). Predictors of lowerHRQoL among CKD children were advanced CKD stages, primarycaregiver other than childâs parent, low hemoglobin, and vitamin Ddeficiency.Conclusions: As in other parts of the world, CAKUT was themain cause of CKD in Ugandan children. The majority of childrenpresented at late CKD stages. HRQoL in CKD was much lowerthan in non-CKD children. Only two thirds of school-eligible CKDchildren actually attended school. Low hemoglobin and vitamin Ddeficiency were potentially modifiable factors associated with lowHRQoL. Simple interventions with iron, erythropoietin stimulatingagent, and vitamin D supplementation might lead to improvedHRQoL.
