Quality of Life in Children at Different Stages of Chronic Kidney Disease in a Developing Country

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Few studies have been conducted in developing countries. Methods: This cross-sectional study included 2–18-year-old patients who were categorized into 4 groups: the CKD stage 2–3, stage 4–5, stage 5 with dialysis (D), and kidney transplantation (KT) groups. QoL was measured using the Pediatric Quality of Life Inventory TM (PedsQL TM ) version 4.0; relationships between different factors and QoL were determined using multivariable linear regression analysis. Results: Eighty-seven patients (mean age: 13.3 (4.1) years) were included. The self-reported total scores were 77.5 (12.5), 78.9 (11.2), 77.4 (16.2), and 76.1 (10.9) in the stage 2-3, stage 4-5, stage 5D and KT groups, respectively. Parent-reported scores showed a weak-to-moderate correlation with self-reported scores ( r =0.12-0.42), with total scores of 71.8 (12.7), 69.5 (14.9), 63.4 (14.8), and 70.8 (18.1) in the stage 2-3, 4-5, 5D and KT groups, respectively. Multivariable linear regression revealed that the parent-reported score in the stage 5D group was 15.92 points lower than that in the early CKD stage group ( p =0.02); the score in the low maternal education group was 10.13 points lower than that in the high maternal education group ( p =0.04). Conclusions: Parent-reported scores showed weak-to-moderate correlation with self-reported scores. CKD stage 5D patients and patients with low maternal education had lower QoL. Regular QoL assessment is recommended for advanced CKD patients and patients with socioeconomic vulnerabilities. Chronic kidney disease quality of life pediatrics PedsQL Introduction In the advanced stages of chronic kidney disease (CKD), pediatric patients frequently encounter numerous hurdles that significantly diminish their quality of life (QoL). These challenges include dietary limitations, reliance on multiple medications, daily activity restrictions, barriers to attending school, compromised cognitive function, and an array of complications such as fluid overload and physical transformation [1–3]. Consequently, the care of pediatric CKD patients necessitates a thorough evaluation that encompasses medical and psychosocial dimensions [4]. QoL is a crucial aspect of psychosocial assessment [4, 5]. Although a dedicated instrument exists for evaluating the QoL of pediatric patients with end-stage kidney disease [6], there is currently a notable absence of a specific assessment tool for assessing QoL in children at other stages of CKD, including the kidney transplantation (KT) stage. The majority of previous research examining QoL in pediatric CKD patients has predominantly relied on the Pediatric Quality of Life Inventory™ (PedsQL™) [7–12]. Conversely, fewer studies have employed the Greek version of the KIDSCREEN, the Turkish versions of the Kinder Lebensqualität Fragebogen (KINDL®) questionnaire, the Health Utilities Index 3 score, and the KoreaN cohort study for Outcome in patients with Pediatric Chronic Kidney Disease (KNOW-PedCKD) [13–16]. A study conducted in Brazil revealed that pediatric patients in advanced stages of CKD (stages 4–5) and those who underwent KT had significantly lower QoL than healthy children [7]. Similarly, research conducted in the United States (US) indicated that even pediatric patients in early CKD stages (stages 2–3) had lower QoL than healthy children [8]. That study further highlighted that factors such as a low maternal education level, short stature, and a prolonged disease duration negatively impacted QoL [8]. Similarly, a study in Uganda, a developing, low-income country without access to dialysis, revealed that patients in advanced CKD stages (stages 3b-5) reported lower QoL than those in early CKD stages (stages 1-3a) [9]. The majority of QoL studies in pediatric patients with CKD have been conducted in developed, high-income countries, where socioeconomic status and medical care significantly differ from those in developing countries, thereby influencing QoL outcomes. Furthermore, despite being conducted in a developing country, a previous study emphasized the difficulties experienced by patients with CKD stage 5 who lack access to dialysis [9]. This underscores the potential impact of the availability of renal replacement therapy on long-term survival and QoL outcomes for CKD stage 5 patients [17, 18]. Although a study on QoL in children with CKD was conducted in Thailand, a developing, upper-middle-income country with access to renal replacement therapy, including dialysis and KT, it revealed similarly low QOL in children with CKD, albeit with a limited sample size of only 25 patients and a focus solely on adolescents aged 11–18 years [10]. The aim of this study was to evaluate the QoL of pediatric patients at different stages of CKD by considering both total scale scores and individual domain scores. Furthermore, the authors aimed to investigate the potential influence of clinical and socioeconomic factors on QoL outcomes. Methods Study population The study population included all patients aged 2–18 years who were diagnosed with CKD stages 2-5D and KT and who were clinically stable for at least 3 months at Siriraj Hospital between September 2022 and November 2023. The exclusion criteria were (i) acute illness within 30 days, (ii) the loss of a family member within 30 days, and (iii) the inability to reply to the questionnaire due to illegibility. Patients and their parents could withdraw if they did not wish to participate at any time after enrollment. Patients who met these criteria were informed of the study, and both parental consent and patient assent were obtained. Clinical data were obtained from electronic patient records and laboratory tests. This study was approved by the Siriraj Hospital Institutional Review Board. Quality of life measurement The Thai version of the PedsQL™ 4.0 Generic Core Scale was utilized to assess QoL in this study. The authors obtained permission to use the Thai version of the PedsQL™ through www.eprovide-mapi-trust.org , with registration number 145835. The questionnaire results were stratified by age group: 2–4, 5–7, 8–12, and 13–18 years. Self-reports were utilized for patients aged 5–18 years, whereas parent reports were employed for patients aged 2–18 years. Only parent-reported data were considered for patients in the 2- to 4-year-old group. The PedsQL comprises 23 questions across 4 domains: the physical (8 questions), emotional (5 questions), social (5 questions), and school functioning (5 questions) domains. Each item is scored from 0 to 4, and the total scores are converted to a scale of 0 to 100, with higher scores indicating better QoL. Clinical definition The estimated glomerular filtration rate (eGFR) was calculated using the Schwartz formula with an enzymatic method of creatinine measurement. CKD stages 2, 3, 4, and 5 were defined as eGFRs of 60–89, 30–59, 15–29, and < 15 ml/min/1.73 m 2 , respectively. CKD stage 5D was defined as CKD stage 5 treated with either peritoneal dialysis or hemodialysis. KT was defined as receiving a kidney from a donor with a functioning allograft. Laboratory results were collected within a 3-month period of enrollment. According to the World Health Organization (WHO), anemia was defined as serum hemoglobin levels < 11.5, < 12, and < 13 g/dL in children aged 6–11.99 years, children aged 12–14.99 years, and male children aged ≥ 15 years, respectively. Hypertension was defined as a blood pressure above the 95th percentile or the use of any antihypertensive medication. The primary caregiver was the main person responsible for the patient. Family income was recorded as the total monthly income, with an exchange rate of 35 Thai baht (THB), approximately equivalent to 1 United States dollar (USD). Statistical analysis Descriptive statistics were used for the general demographic data of the patients. Continuous normally distributed data are presented as the means and standard deviations (SDs), while nonnormally distributed continuous data are presented as medians and interquartile ranges (IQRs). Categorical data are expressed using numbers and percentages. For the comparison of categorical variables, Pearson’s chi-square test was utilized. For continuous variables, either one-way ANOVA or the Kruskal‒Wallis test was employed, chosen based on the distribution of the data. A p value < 0.05 was considered to indicate statistical significance. The mean differences between self-reported and parent-reported scores were analyzed by paired Student’s t tests. The Pearson correlation coefficient ( r ) was calculated and used to analyze QoL scores between self-reports and parent-reports. Very strong, strong, moderate, weak, and negligible correlations were defined as values of 0.90-1.00, 0.70–0.89, 0.40–0.69, 0.10–0.39, and less than 0.10, respectively [19]. Relationships between factors and PedsQL scores were identified using univariable and multivariable linear regression analyses. Any variables that were either significant in the univariable logistic regression analysis ( p < 0.2) or clinically significant were selected as candidates for multivariable linear regression analysis using the enter method. A p value < 0.05 was considered to indicate statistical significance. All the statistical calculations were performed using IBM SPSS Statistics version 29 (IBM Corp, Armonk, NY, USA). Results Demographic and clinical characteristics of patients at different stages of CKD Patients aged 2 to 18 years with CKD stages 2-5D, including KT , were screened for eligibility from September 2022 to November 2023. None of the patients met the exclusion criteria; therefore, all 87 patients were included. Both the patients and their parents completed the PedsQL questionnaire. A comparison of demographic and clinical characteristics among patients with different stages of CKD is presented in Table 1. Overall, the mean age was 13.3 (4.1) years, and 57.5% of the patients were male. The common causes of CKD were glomerular disease (28.7%), congenital anomalies of the kidney and urinary tract (CAKUT) (21.8%), and neurogenic bladder (21.8%). Urinary catheters were used in 19 (21.8%) patients due to a neurogenic bladder. The majority of patients (62.1%) were diagnosed with hypertension, and approximately half of the patients met the criteria for anemia. In addition, there were no differences in sex, height, weight, or hypertension among the groups. However, patients in the KT group were older than those in the other groups were ( p =0.02). The majority of patients in the CKD stage 5D and KT groups had glomerular disease, while the causes of CKD in the CKD stages 2-3 and 3-5 groups included both neurogenic bladder and others ( p =0.04). Most patients who used urinary catheters were in the CKD stage 2-3 and stage 3-4 groups ( p =0.005). Patients in the CKD stage 5D and KT groups were treated with a greater number of medications, with a median of 10 (7.0, 11.0) ( p <0.001), and patients in the CKD stage 5D group had a greater incidence of anemia than did those in the other groups ( p <0.001). Socioeconomic characteristics of patients at different stages of chronic kidney disease The socioeconomic characteristics are summarized in Table 2, and there were no differences in socioeconomic characteristics among the groups. The majority of patients received education within the system (80.5%), which included school, college, and university. All of the patients were covered under the universal coverage scheme. Approximately half of the patients (46%) resided in rural communities, with the majority living in their home (77%). Regarding family characteristics, 77% belonged to complete families, with a median of 4.5 (2, 9) family members. The median monthly family income per household was 20,000 (15,000, 40,000) THB or approximately 571 (428, 1,142) USD. The main caregivers were predominantly parents (92.0%), which was consistent across all groups. Most mothers (70.6%) and fathers (81.2%) had a high school education or lower. Additionally, the majority of the parents were employed (82.4% of mothers and 95.1% of fathers) and were in good health (73.3% of mothers and 68.4% of fathers). PedsQL scores and the correlation between self-reported and parent-reported scores among the different CKD stage groups Table 3 presents PedsQL score correlations between self-reported scores and parent-reported scores among different the CKD stage groups. The analysis included 83 pairs of reports, excluding patients aged 2-4 years due to exclusive parent-reported responses in this age group. Weak-to-moderate correlations were observed between self-reported and parent-reported total PedsQL scores in the CKD stage 2-3 ( r =0.12), stage 4-5 ( r =0.42), stage 5D ( r =0.41), and KT groups ( r =0.42). Additionally, the correlations between self-reported and parent-reported scores on various PedsQL domains ranged from negligible to moderate among the different CKD stage groups (r= -0.76 to 0.53). In all CKD stage groups and PedsQL domains, parent-reported scores consistently exceeded self-reported scores. Overall, self-reported physical, social, school, and total scores were significantly greater ( p <0.05). In the CKD stage 2-3 group, self-reported scores were significantly greater for emotional functioning ( p <0.05). In the CKD stage 4-5 group, self-reported social, school functioning, and total scores were significantly greater ( p <0.05). For CKD stage 5D patients, self-reported scores were significantly greater for all dimensions and the total score ( p <0.05). Similarly, in the KT group, self-reported scores were significantly greater for school functioning ( p <0.05). The self-reported total scores were 77.5 (12.5), 78.9 (11.2), 77.4 (16.2), and 76.1 (10.9) in the CKD stage 2-3, stage 4-5, stage 5D and KT groups, respectively. Parent-reported total scores showed weak-to-moderate correlations with self-reported scores ( r =0.12-0.42), with scores of 71.8 (12.7), 69.5 (14.9), 63.4 (14.8), and 70.8 (18.1) in the CKD stage 2-3, stage 4-5, stage 5D and KT groups, respectively. While self-reported PedsQL total scores and domain scores did not significantly differ among the CKD stage groups, parent-reported PedsQL scores revealed notable distinctions. According to parent reports, with the CKD stage 5D group consistently had the lowest scores across all domains compared to other groups, but this difference was not statistically significant. For instance, for physical functioning, the parent-reported scores were 63.1 (16.9) for the CKD stage 5D group, 71.9 (18.4) for the CKD stage 2-3 group, 70.1 (24) for the CKD stage 4-5 group, and 70.9 (22.6) for the KT group ( p =0.38). Similar patterns were observed in the emotional ( p =0.54), social ( p =0.40), and school functioning domains ( p =0.15), where the CKD stage 5D group consistently showed the lowest scores among the groups. The relationships between different factors and self-reported and parent-reported PedsQL scores A univariable linear regression analysis was performed to explore the relationships between different factors and PedsQL scores, as presented in Table 4. The univariable linear regression analysis of self-reported scores revealed no statistically significant associations. In contrast, the univariable linear regression analysis of parent-reported scores identified CKD stage 5D ( β :-8.3, 95% CI: (-15.93, -0.67, p =0.03) and a low maternal education level ( β :-8.19, -15.29, -1.08, p =0.03) as potential factors associated with PedsQL scores. Other risk factors were not statistically significant. A total of 87 patients were included in this study; hence, 9 factors could be selected as candidates for the multivariate linear regression analysis model (with 10 patients per factor). The results of the multivariate linear regression analysis (Table 5) for parent reports identified CKD stage ( p =0.03 in CKD stage 5D patients), height <3 rd percentile ( p =0.21, clinically significant), anemia ( p =0.14), number of medications ( p =0.53, clinically significant), leaving school ( p =0.88, clinically significant), not living with parents ( p =0.46, clinically significant), low family income ( p =0.94, clinically significant), a low maternal education level ( p =0.02), and a low paternal education ( p =0.35, clinically significant) as factors for the final model built using the enter method. Notably, CKD stage 5D patients and patients whose mothers had low education levels were significantly associated with PedsQL scores that were 15.92 points ( p =0.02) and 10.13 points ( p =0.04) lower, respectively, than those of patients in the early stages of CKD and whose mothers had high education levels. Discussion This study aimed to assess QOL scores in children at different stages of CKD in a developing country and to identify the potential impact of clinical and socioeconomic factors on QoL outcomes. The parent-reported total scores were 71.8 (12.7), 69.5 (14.9), 63.4 (14.8), and 70.8 (18.1) in the CKD stage 2–3, stage 4–5, stage 5D and KT groups, respectively. Notably, parent-reported scores consistently lagged behind self-reported scores at all CKD stages, showing a weak-to-moderate correlation ( r = 0.12–0.42). Additionally, in parent-reported assessments, the score of the CKD stage 5D group was significantly lower than that of the early-stage CKD group (by 15.92 points ( p = 0.02)), while the low maternal education group score was 10.13 points lower than that of the high maternal education group ( p = 0.04). The patients included in this study had clinical characteristics similar to those of the populations of studies on QoL in pediatric patients with CKD, including age, sex, etiology of CKD, and anemia [7–9, 11, 12] The majority of patients in this study were adolescents with a mean age of 13.3 years, and the common etiologies of CKD were glomerular disease, CAKUT, and neurogenic bladder. The socioeconomic status in this study was lower than those observed in studies conducted in developed countries [8]. In contrast to studies conducted in developed countries where the maternal education level predominantly exceeded high school levels [8], the majority of mothers in this study had a high school education or lower, similar to findings in another study conducted in a developing country [9]. The main caregivers in this study were parents, and most of the children lived with a full family structure, similar to the findings of other studies [7, 9, 11]. Previous pediatric research has shown that pediatric patients with CKD tend to have lower QoL than healthy children [7–12]. Similarly, this study reaffirms these observations, demonstrating that pediatric patients at all stages of CKD exhibited reduced QoL when compared to healthy Thai children, as studied by Sritipsukho et al. [20]. Additionally, Lopes et al. [7] demonstrated that individuals with CKD stage 5D had lower total, physical, emotional, and school domain scores than KT patients did. Similarly, this study underscores this disparity, revealing that patients with CKD stage 5D, as reported by parents, had lower QoL scores across all domains than patients in other CKD groups. In a previous study [8], no significant difference was found between parent- and self-reported PedsQL scores, with some studies suggesting higher scores from parent-reported assessments than from self-reported assessments [7, 9]. Conversely, other studies indicated lower PedsQL scores in parent-reported assessments than in self-reported assessments [10, 12]. This study supports these findings, demonstrating a lack of correlation between parent-reported and self-reported scores. Parent-reported assessments consistently revealed lower PedsQL scores than self-reported assessments across all stages of CKD and domains, which was particularly notable in patients in advanced stages of CKD (stage 4-5D). This discrepancy may arise because parents often consider the overall well-being of their children, whereas the children themselves may not perceive certain issues from their childlike perspective. Additionally, the heightened caregiving responsibilities undertaken by parents for pediatric patients with CKD, especially in advanced stages, can lead to elevated stress levels and increased financial burdens for caregivers [21]. A multicenter study of adults revealed both physical and mental burdens in patients receiving either peritoneal dialysis or hemodialysis [22]. Similarly, this study demonstrated that patients with CKD stage 5D had significantly lower parent-reported PedsQL scores (by 15.92 points) than patients with CKD in the early stages. One potential explanation is that patients with CKD stage 5 typically undergo complex medication regimens with multiple doses throughout the day, experience physical weakness including failure to thrive, face dietary restrictions, often miss school due to medical appointments or hospital admissions, rely on hemodialysis or peritoneal dialysis machines for treatment, and may experience feelings of depression [2]. In this study, a significant association was observed between low maternal education levels and parent-reported PedsQL scores: the parent-reported PedsQL score was 10.13 points lower in the low maternal education group than in the high maternal education group. These findings are in line with a previous study by Gerson et al. [8], which identified a relationship between low maternal education levels and QoL in patients with mild to moderate CKD. Moreover, a low maternal education level has been shown to impact children’s QoL across various diseases, including thalassemia, cancer, type 1 diabetes mellitus, asthma, and overweight/obesity [23–25]. One potential explanation is that a lower maternal education level is often correlated with a lower household income level, resulting in limited access to nutritious food, safe housing, and educational opportunities. Additionally, a low maternal education level is often associated with increased stress and limited knowledge and skills to provide support and guidance to children. These factors can collectively impact the QoL of a child. Additional potential factors associated with QoL in patients with CKD, as reported in previous pediatric studies [8], include younger age and short stature. However, these variables were not found to be statistically significant in this study. This study has several strengths. First, this study encompassed a relatively large population compared to a previous study conducted in Thailand [10] that utilized the same PedsQL instrument. Second, the population encompassed a wide range of ages, from 2 to 18 years, rather than being limited to a specific age group. Third, the generalizability of this study to all children with CKD in developing countries is notable. While conducted in a tertiary center, approximately half of the patients resided in rural areas and were referred from local hospitals across all regions of Thailand. Fourth, this study examined the relationships between different factors and QoL. Based on a review of the literature, only one previous study conducted in a developed country investigated this variable [8]. This study revealed that CKD stage 5D and low maternal education levels were associated with low QoL, and these results expand on those in the literature. Our study also has several limitations. First, this was a cross-sectional study assessing QoL in patients with CKD. However, QoL is subject to change over time due to various factors, such as alterations in health status, socioeconomic circumstances, and life events. Therefore, a longitudinal analysis could provide more comprehensive information regarding the dynamic nature of QoL in this population. Second, this study employed the PedsQL, relying on information provided by the patients and their parents. As a result, the assessment of school functioning may not be entirely accurate due to the absence of first-hand data during school hours. Therefore, supplementing the data with information obtained from teachers regarding learning issues would contribute to the comprehensiveness of the dataset. Third, there was no comparison of QoL between the patients with CKD and healthy controls in this study. However, our study revealed lower QoL scores in pediatric patients with CKD than in healthy Thai children, as studied by Sritipsukho et al. [20]. Therefore, there is a need for additional prospective longitudinal studies to assess QoL among patients at various stages of CKD while incorporating teacher assessments of school functioning. Additionally, comparing these findings with those of a healthy control group would further validate the outcomes of this study. In conclusion, this study demonstrated a significant association between low QoL and CKD stage 5, as well as between low QoL and low maternal education levels. We recommend regular QoL assessment for children with advanced CKD and those at socioeconomic risk. Declarations Funding This study was funded by the Research Department, Siriraj Hospital, Faculty of Medicine, Mahidol University, Bangkok, Thailand (grant number (IO) R016531074). Competing interests The authors declare no competing interests. Ethics approval This study was approved by the Institutional Review Board of Siriraj Hospital. Consent to participate Informed assent and consent were obtained from all participants and their parents. Consent for publication Not applicable. Data Availability Not applicable. Code availability Not applicable. Authors’ contribution Urapee Chaichana recruited participants, collected the data, performed the analysis, interpreted the data, drafted the initial manuscript, and approved the final manuscript for submission. Julaporn Pooliam performed the analysis, interpreted the data and approved the final manuscript for submission. Maturin Jantongsree invited participants, collected the data, assisted with financial documentation and approved the final manuscript for submission. Sasithorn Chantaratin interpreted the data, revised the work critically for important intellectual content and approved the final manuscript for submission. Achra Sumboonnanonda interpreted the data, revised the work critically for important intellectual content and approved the final manuscript for submission. Anirut Pattaragarn interpreted the data, revised the work critically for important intellectual content and approved the final manuscript for submission. Suroj Supavekin interpreted the data, revised the work critically for important intellectual content and approved the final manuscript for submission. Nuntawan Piyaphanee interpreted the data, revised the work critically for important intellectual content and approved the final manuscript for submission. Kraisoon Lomjansook interpreted the data, revised the work critically for important intellectual content and approved the final manuscript for submission. Yarnarin Thunsiribuddhicha interpreted the data, revised the work critically for important intellectual content and approved the final manuscript for submission. Intraparch Tinnabut created a form in Excel for calculating QoL scores and approved the final manuscript for submission. Thanaporn Chaiyapak made substantial contributions to the conception of the study, designed the study, interpreted the data, revised the work critically for important intellectual content, and approved the final manuscript for submission. 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Biomed Res Int 2018:8485103. https://doi.org/10.1155/2018/8485103 Costa D, Cunha M, Ferreira C, Gama A, Machado-Rodrigues AM, Rosado-Marques V, Mendes LL, Nogueira H, Pessoa M, Silva MG, Velasquez-Melendez G, Padez C (2021) Socioeconomic inequalities in children's health-related quality of life according to weight status. Am J Hum Biol 33:e23453. https://doi.org/10.1002/ajhb.23453 Tables Table 1. Comparison of demographic and clinical characteristics of patients at different stages of chronic kidney disease Characteristics CKD stage 2–3, n (%) n = 29 CKD stage 4–5, n (%) n = 19 CKD stage 5D a , n (%) n = 20 Kidney transplant, n (%) n = 19 Total n = 87 P Male 17 (58.6) 10 (52.6) 12 (60) 11 (57.9) 50 (57.5) 0.98 Age, years (SD) 12.3 (4.6) 11.9 (3.8) 14.0 (4.1) 15.4 (1.9) 13.3 (4.1) 0.02 Cause of CKD Glomerular disease 4 (13.8) 4 (21.1) 9 (45) 8 (42.1) 25 (28.7) 0.04 CAKUT 5 (17.2) 5 (26.3) 6 (30) 3 (15.8) 19 (21.8) Neurogenic bladder 9 (31) 5 (26.3) 1 (5) 4 (21.1) 19 (21.8) Unknown 0 (0) 0 (0) 2 (10) 2 (10.5) 4 (4.6) Others 11 (37.9) 5 (26.3) 2 (10) 2 (10.5) 20 (23) Height, cm (SD) 141.0 (23.2) 138.8 (17.7) 147.8 (20.5) 148.5 (14.2) 143.7 (19.8) 0.30 Weight, kg (SD) 41.8 (20.7) 36.4 (12.4) 50.7 (29.3) 48.1 (12.6) 44.0 (20.6) 0.12 Urinary catheter use 9 (31) 8 (42.1) 2 (10) 0 (0) 19 (21.8) 0.005 Number of medications, median (IQR) 2 (0, 4.0) 6 (3.0, 8.0) 12 (9.3, 15.0) 10 (7.0, 11.0) 7 (0, 21.0) < 0.001 Hypertension 14 (48.3) 10 (52.6) 17 (85) 13 (68.4) 54 (62.1) 0.16 Anemia 9 (31) 11 (57.9) 19 (95) 10 (52.6) 49 (56.3) < 0.001 Abbreviations: CAKUT: congenital anomalies of the kidney and urinary tract; CKD: chronic kidney disease; cm: centimeter; D: dialysis; IQR: interquartile range; kg: kilogram; SD: standard deviation. Notes: a Including peritoneal dialysis and hemodialysis. Table 2. Comparison of socioeconomic characteristics of patients at different stages of chronic kidney disease Characteristics CKD stage 2–3, n (%) n = 29 CKD stage 4–5, n (%) n = 19 CKD stage 5D a , n (%) n = 20 Kidney transplant, n (%) n = 19 Total n = 87 P Type of education School/college/university 25 (86.2) 17 (89.5) 13 (65) 15 (78.9) 70 (80.5) 0.69 Informal education 0 (0) 0 (0) 4 (20) 3 (15.8) 7 (8) Children who left school 2 (6.9) 2 (10) 3 (15) 1 (5.3) 8 (9.2) Underage 2 (6.9) 0 (0) 0 (0) 0 (0) 2 (2.3) Universal Coverage Scheme 29 (100) 19 (100) 20 (100) 19 (100) 87 (100) NA Lives in a rural area 11 (37.9) 7 (36.8) 9 (45) 13 (68.4) 40 (46) 0.16 Type of residence House/townhouse 26 (89.7) 19 (100) 20 (100) 17 (89.5) 82 (94.3) 0.23 Apartment/flat/condominium 3 (10.3) 0 (0) 0 (0) 2 (10.5) 5 (5.7) House owner 21 (72.4) 15 (78.9) 16 (80) 15 (78.9) 67 (77) 0.91 Family structure Full 21 (72.4) 15 (78.9) 16 (80) 15 (78.9) 67 (77) 0.65 Single parent 6 (20.7) 4 (21.1) 2 (10) 4 (21.1) 16 (18.4) Not living with parents 1 (3.4) 0 (0) 2 (10) 0 (0) 3 (3.4) Number of family members, (IQR) 4 (4.0, 6.0) 4 (3.0, 4.0) 4.5 (4.0, 5.8) 4 (3.0, 5.0) 4.5 (2.0, 9.0) 0.07 Siblings 21 (72.4) 11 (57.9) 17 (85) 10 (52.6) 59 (67.8) 0.12 Family income, 10,000 THB (IQR) 2 (1.5, 4.0) 2 (1.0, 4.0) 2 (1.2, 3.8) 2 (1.0, 5.0) 2 (1.5, 4.0) 0.97 Main caregiver Parents 26 (89.7) 17 (89.5) 18 (90) 19 (100) 80 (92) 0.55 Grandparents/others 2 (6.9) 1 (5.3) 0 (0) 0 (0) 3 (3.4) Others 1 (3.4) 1 (5.3) 2 (10) 0 (0) 4 (4.6) Maternal data (n = 85) Age, years (SD) 42.9 (7.8) 39 (7.3) 41.3 (6.1) 42.8 (7.8) 41.7 (7.4) 0.31 Highest education High school or lower 20 (71.4) 14 (73.6) 15 (78.9) 11 (57.9) 60 (70.6) 0.49 Bachelor’s degree or higher 8 (28.6) 5 (26.4) 4 (21.1) 8 (42.1) 25 (29.4) Employment 21 (21) 18 (94.7) 15 (75) 16 (84.2) 70 (82.4) 0.36 Healthy 19 (67.9) 15 (78.9) 13 (65) 16 (84.2) 63 (73.3) 0.46 Paternal data (n = 85) Age, years (IQR) 45 (38.3, 49.3) 42.5 (40.3, 46.3) 44.5 (35.0, 49.3) 46 (38.0, 52.0) 45 (38.0, 49.0) 0.68 Highest education High school or lower 25 (89.3) 13 (72.2) 18 (90) 13 (68.4) 69 (81.2) 0.69 Bachelor’s degree or higher 3 (10.7) 5 (27.8) 2 (10) 6 (31.6) 16 (18.8) Employment 25 (96.2) 17 (94.4) 19 (95) 17 (94.4) 78 (95.1) 0.99 Healthy 18 (69.2) 11 (64.7) 15 (83.3) 10 (55.6) 54 (68.4) 0.34 Abbreviations: CKD: chronic kidney disease; D: dialysis; IQR: interquartile range; NA: not applicable; THB: thai baht. Notes: a Including peritoneal dialysis and hemodialysis. b 10,000 THB is equal to approximately 350 United States dollars (USD). Table 3. PedsQL scores and the correlation between self-reported and parent-reported scores among the different CKD stage groups Variables CKD stage 2–3 (n = 27) mean (SD) CKD stage 4–5 (n = 18) mean (SD) CKD stage 5D a (n = 20) mean (SD) Kidney transplant (n = 19) mean (SD) Total (n = 84) mean (SD) Self-reports Parent-reports r Self-reports Parent-reports r Self-reports Parent-reports r Self-reports Parent-reports r Self-report Parent-reports r Physical functioning 82.2 (12.9) 71.9 (18.4) 0.31 79.9 (12.7) 70.1 (21.4) 0.14 77.3 (15.2) * 63.1 (16.9) 0.45 75.8 (18.1) 70.9 (22.6) 0.41 79.1 (13.6) * 69.8 (19.8) 0.33 Emotional functioning 72.8 (18.9) * 73.5 (14.7) 0.45 75.0 (15.9) 69.4 (12.9) 0.13 77.8 (21.9) * 66.8 (19.2) 0.42 74.5 (20.1) 71.6 (20.3) 0.43 74.8 (19.1) 71.1 (16.8) 0.37 Social functioning 83.3 (15.9) 77.2 (17.3) 0.12 87.8 (14.3) * 73.6 (18.2) 0.46 88.0 (17.9) * 70.0 (17.4) 0.47 79.4 (13.7) 79.2 (19.0) 0.32 84.5 (15.7) * 75.9 (17.9) 0.27 School functioning 71.7 ± 14.6 64.4 ± 17.4 −0.76 73.3 (12.7) * 65.0 (19.1) 0.53 66.5 (20.1) * 54.2 (20.5) 0.40 74.7 (12.6) * 61.6 (20.7) 0.03 71.5 (15.4) * 62.5 (19.9) 0.24 Total score 77.5 ± 12.5 71.8 ± 12.7 0.12 78.9 (11.2) * 69.5 (14.9) 0.42 77.4 (16.2) * 63.4 (14.8) 0.41 76.1 (10.9) 70.8 (18.1) 0.42 77.5 (12.7) * 69.8 (15.4) 0.31 Abbreviations: CKD: chronic kidney disease; D: dialysis; PedsQL: pediatric quality of life inventory; SD: standard deviation; r : correlation. a Including peritoneal dialysis and hemodialysis. * Difference between self and parent reports; p < 0.05. Table 4. Univariable linear regression analyses of the relationships between different factors and self- and parent-reported PedsQL scores Characteristics Self-reported scores Parent-reported scores β (unstandardized coefficients) (95% CI) P β (unstandardized coefficients) (95% CI) P Clinical characteristics Age 0.49 (−0.27, 1.25) 0.21 −0.13 (−0.95, 0.69) 0.75 Female −1.38 (−9.12, 2) 0.21 0.34 (−6.33, 7.01) 0.92 CKD stage −0.11 (−6.63, 6.41) 0.97 −8.30 (−15.93, −0.67) CKD stage 2–3 Reference Reference CKD stage 4–5 1.51 (−6.31, 9.32) 0.70 1.59 (−6.38, 9.57) 0.69 CKD stage 5D a −0.09 (−7.67, 7.49) 0.98 −8.3 (−15.93, −0.67) 0.03 Kidney transplant −1.36 (−9.06, 6.33) 0.73 1.29 (−6.68, 9.28) 0.75 Height < 3 rd percentile 0.93 (−5.58, 7.44) 0.78 0.15 (−0.09, 0.39) 0.21 Weight < 3 rd percentile 1.23 (−6.44, 8.90) 0.75 −3.49 (−12.71, 5.73) 0.45 Cause of CKD CAKUT Reference Reference Glomerular disease −3.42 (−11.33, 4.49) 0.39 0.80 (−8.24, 9.85) 0.86 Neurogenic bladder −0.48 (−9.14, 8.17) 0.91 9.78 (0.14, 19.42) 0.047 Unknown −0.27 (−8.25, 7.71) 0.95 −2.87 (−11.99, 6.26) 0.53 Urinary catheter use 3.38 (−3.49, 10.25) 0.33 4.33 (−3.59, 12.26) 0.28 Number of medications −0.23 (0.57, 5.20) 0.93 −0.21 (−0.86, 0.45) 0.53 Hypertension 0.67 (−4.81, 6.18) 0.81 0.81 (−5.75, 7.38) 0.81 Anemia −0.76 (−6.39, 4.87) 0.79 −4.90 (−11.46, 1.67) 0.14 Socioeconomic characteristics Children who left school 4.31 (−5.69, 14.31) 0.39 −0.90 (−12.31, 10.52) 0.88 Live in rural area 1.70 (−3.86, 7.25) 0.55 −2.69 (−9.28, 3.90) 0.42 Not living with parents −1.37 (−17.45, 14.72) 0.87 −11.30 (−11.68, 5.37) 0.46 Number of family members −0.17 (−2.01, 1.69) 0.86 0.29 (−1.95, 2.52) 0.80 Family income > 10,000 THBb 1.07 (−7.15, 9.29) 0.80 0.38 (−10.30, 9.55) 0.94 Maternal education level: high school or less 2.41 (−3.77, 8.59) 0.44 −8.19 (−15.29, −1.08) 0.03 Paternal education level: high school or less 5.73 (−1.45, 12.92) 0.12 −4.02 (−12.49, 4.46) 0.35 Main caregiver not parents; grandparents 1.65 (−8.39, 11.69) 0.74 −0.67 (−12.80, 11.44) 0.91 Abbreviations: 95% CI: 95% confidence interval; CKD: chronic kidney disease; D: dialysis; PedsQL: pediatric quality of life inventory; THB: thai baht; β: unstandardized coefficients. Notes: a Including peritoneal dialysis and hemodialysis. b 10,000 THB is equal to approximately 350 United States dollars (USD). The β coefficient indicates the difference in the domain z score per 1-point increase in the PedsQL score. Table 5. Multivariable linear regression analyses of the relationships between different factors and self- and parent-reported PedsQL scores Characteristics Child self-report Parent report Univariate linear regression analysis Multivariate linear regression analysis Univariate linear regression analysis Multivariate linear regression analysis β (unstandardized coefficients) (95% CI) P β (unstandardized coefficients) (95% CI) P β (unstandardized coefficients) (95% CI) P β (unstandardized coefficients) (95% CI) P CKD stage CKD stage 4–5 1.51 (−6.31, 9.32) 0.70 2.97 (−6.66, 12.60) 0.54 1.59 (−6.38, 9.57) 0.69 −3.64 (−13.98, 6.70) 0.49 CKD stage 5D a −0.09 (−7.67, 7.49) 0.98 0.97 (−11.32, 13.25) 0.88 −8.3 (−15.93, −0.67) 0.03 −15.92 (−29.42, −2.43) 0.02 Kidney transplant −1.36 (−9.06, 6.33) 0.73 0.54 (−10.84, 11.91) 0.93 1.29 (−6.68, 9.28) 0.75 −10.89 (−23.42, 1.64) 0.09 Height < 3 rd percentile 0.93 (−5.58, 7.44) 0.78 0.63 (−7.50, 8.75) 0.88 0.15 (−0.09, 0.39) 0.21 8.14 (−0.90, 17.17) 0.08 Anemia −0.76 (−6.39, 4.87) 0.79 −1.11 (−8.59, 6.37) 0.77 −4.90 (−11.46, 1.67) 0.14 −3.00 (−11.18, 5.19) 0.47 Number of medications −0.23 (−0.57, 0.53) 0.93 −0.01 (−0.93, 0.91) 0.98 −2.06 (−0.86, 0.45) 0.53 0.77 (−0.25, 1.78) 0.14 Children who left school 4.31 (−5.69, 14.31) 0.39 3.50 (−8.49, 15.50) 0.56 −0.90 (−12.31, 10.52) 0.88 2.26 (−9.85, 14.38) 0.71 Not living with parents −1.37 (−17.45, 14.72) 0.87 −4.91 (−25.19, 15.37) 0.63 −11.30 (−11.68, 5.37) 0.46 −8.94 (−31.47, 13.59) 0.43 Family income (< 10,000 THB) b 1.07 (−7.15, 9.29) 0.80 1.45 (−8.74, 11.64) 0.78 0.38 (−9.55, 10.30) 0.94 −9.79 (−21.10, 1.51) 0.09 Maternal education level: high school or less 2.41 (−3.77, 8.59) 0.44 −0.86 (−9.54, 7.82) 0.84 −8.19 (−15.29, −1.08) 0.02 −10.13 (−19.66, −0.60) 0.04 Paternal education level: high school or less 5.73 (−1.45, 12.92) 0.12 6.69 (−3.20, 16.58) 0.18 −4.02 (−12.49, 4.46) 0.35 1.61 (−9.31, 12.53) 0.77 Abbreviations: 95% CI: 95% confidence interval; CKD: chronic kidney disease; D: dialysis; PedsQL: pediatric quality of life inventory; THB: thai baht; β: unstandardized coefficients. Notes: a Including peritoneal dialysis and hemodialysis. b 10,000 THB is equal to approximately 290 United States dollars (USD). The β coefficient indicates the difference in the domain z score per 1-point increase in the PedsQL score. Cite Share Download PDF Status: Published Journal Publication published 10 Aug, 2024 Read the published version in Pediatric Nephrology → Version 1 posted Reviewers agreed at journal 13 Mar, 2024 Reviewers invited by journal 12 Mar, 2024 Editor assigned by journal 11 Mar, 2024 First submitted to journal 09 Mar, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4055574","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":278860738,"identity":"413bb07e-f88d-40be-8e68-ad8eb42e0f2b","order_by":0,"name":"Urapee Chaichana","email":"","orcid":"","institution":"Mahidol University Faculty of Medicine Siriraj Hospital Department of Pediatrics","correspondingAuthor":false,"prefix":"","firstName":"Urapee","middleName":"","lastName":"Chaichana","suffix":""},{"id":278860739,"identity":"f32a8472-cfe0-478b-860b-88fba93946d2","order_by":1,"name":"Maturin 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Pediatrics","correspondingAuthor":true,"prefix":"","firstName":"Thanaporn","middleName":"","lastName":"Chaiyapak","suffix":""}],"badges":[],"createdAt":"2024-03-09 11:46:28","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4055574/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4055574/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1007/s00467-024-06442-1","type":"published","date":"2024-08-10T15:57:39+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":62298902,"identity":"bbd8a001-3fc0-4316-8ce2-a91f73d0bc29","added_by":"auto","created_at":"2024-08-12 16:17:07","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":918006,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4055574/v1/552359fb-2250-4d62-a6c5-ac1f7f3b696f.pdf"}],"financialInterests":"","formattedTitle":"Quality of Life in Children at Different Stages of Chronic Kidney Disease in a Developing Country","fulltext":[{"header":"Introduction","content":"\u003cp\u003eIn the advanced stages of chronic kidney disease (CKD), pediatric patients frequently encounter numerous hurdles that significantly diminish their quality of life (QoL). These challenges include dietary limitations, reliance on multiple medications, daily activity restrictions, barriers to attending school, compromised cognitive function, and an array of complications such as fluid overload and physical transformation [1\u0026ndash;3]. Consequently, the care of pediatric CKD patients necessitates a thorough evaluation that encompasses medical and psychosocial dimensions [4]. QoL is a crucial aspect of psychosocial assessment [4, 5]. Although a dedicated instrument exists for evaluating the QoL of pediatric patients with end-stage kidney disease [6], there is currently a notable absence of a specific assessment tool for assessing QoL in children at other stages of CKD, including the kidney transplantation (KT) stage. The majority of previous research examining QoL in pediatric CKD patients has predominantly relied on the Pediatric Quality of Life Inventory\u0026trade; (PedsQL\u0026trade;) [7\u0026ndash;12]. Conversely, fewer studies have employed the Greek version of the KIDSCREEN, the Turkish versions of the Kinder Lebensqualit\u0026auml;t Fragebogen (KINDL\u0026reg;) questionnaire, the Health Utilities Index 3 score, and the KoreaN cohort study for Outcome in patients with Pediatric Chronic Kidney Disease (KNOW-PedCKD) [13\u0026ndash;16].\u003c/p\u003e \u003cp\u003eA study conducted in Brazil revealed that pediatric patients in advanced stages of CKD (stages 4\u0026ndash;5) and those who underwent KT had significantly lower QoL than healthy children [7]. Similarly, research conducted in the United States (US) indicated that even pediatric patients in early CKD stages (stages 2\u0026ndash;3) had lower QoL than healthy children [8]. That study further highlighted that factors such as a low maternal education level, short stature, and a prolonged disease duration negatively impacted QoL [8]. Similarly, a study in Uganda, a developing, low-income country without access to dialysis, revealed that patients in advanced CKD stages (stages 3b-5) reported lower QoL than those in early CKD stages (stages 1-3a) [9]. The majority of QoL studies in pediatric patients with CKD have been conducted in developed, high-income countries, where socioeconomic status and medical care significantly differ from those in developing countries, thereby influencing QoL outcomes. Furthermore, despite being conducted in a developing country, a previous study emphasized the difficulties experienced by patients with CKD stage 5 who lack access to dialysis [9]. This underscores the potential impact of the availability of renal replacement therapy on long-term survival and QoL outcomes for CKD stage 5 patients [17, 18]. Although a study on QoL in children with CKD was conducted in Thailand, a developing, upper-middle-income country with access to renal replacement therapy, including dialysis and KT, it revealed similarly low QOL in children with CKD, albeit with a limited sample size of only 25 patients and a focus solely on adolescents aged 11\u0026ndash;18 years [10].\u003c/p\u003e \u003cp\u003eThe aim of this study was to evaluate the QoL of pediatric patients at different stages of CKD by considering both total scale scores and individual domain scores. Furthermore, the authors aimed to investigate the potential influence of clinical and socioeconomic factors on QoL outcomes.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy population\u003c/h2\u003e \u003cp\u003eThe study population included all patients aged 2\u0026ndash;18 years who were diagnosed with CKD stages 2-5D and KT and who were clinically stable for at least 3 months at Siriraj Hospital between September 2022 and November 2023. The exclusion criteria were (i) acute illness within 30 days, (ii) the loss of a family member within 30 days, and (iii) the inability to reply to the questionnaire due to illegibility. Patients and their parents could withdraw if they did not wish to participate at any time after enrollment. Patients who met these criteria were informed of the study, and both parental consent and patient assent were obtained.\u003c/p\u003e \u003cp\u003eClinical data were obtained from electronic patient records and laboratory tests. This study was approved by the Siriraj Hospital Institutional Review Board.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eQuality of life measurement\u003c/h2\u003e \u003cp\u003eThe Thai version of the PedsQL\u0026trade; 4.0 Generic Core Scale was utilized to assess QoL in this study. The authors obtained permission to use the Thai version of the PedsQL\u0026trade; through \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e\u003ca href=\"http://www.eprovide-mapi-trust.org\" target=\"_blank\"\u003ewww.eprovide-mapi-trust.org\u003c/a\u003e\u003c/span\u003e\u003cspan address=\"http://www.eprovide-mapi-trust.org\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e, with registration number 145835. The questionnaire results were stratified by age group: 2\u0026ndash;4, 5\u0026ndash;7, 8\u0026ndash;12, and 13\u0026ndash;18 years. Self-reports were utilized for patients aged 5\u0026ndash;18 years, whereas parent reports were employed for patients aged 2\u0026ndash;18 years. Only parent-reported data were considered for patients in the 2- to 4-year-old group. The PedsQL comprises 23 questions across 4 domains: the physical (8 questions), emotional (5 questions), social (5 questions), and school functioning (5 questions) domains. Each item is scored from 0 to 4, and the total scores are converted to a scale of 0 to 100, with higher scores indicating better QoL.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eClinical definition\u003c/h2\u003e \u003cp\u003eThe estimated glomerular filtration rate (eGFR) was calculated using the Schwartz formula with an enzymatic method of creatinine measurement. CKD stages 2, 3, 4, and 5 were defined as eGFRs of 60\u0026ndash;89, 30\u0026ndash;59, 15\u0026ndash;29, and \u0026lt;\u0026thinsp;15 ml/min/1.73 m\u003csup\u003e2\u003c/sup\u003e, respectively. CKD stage 5D was defined as CKD stage 5 treated with either peritoneal dialysis or hemodialysis. KT was defined as receiving a kidney from a donor with a functioning allograft. Laboratory results were collected within a 3-month period of enrollment. According to the World Health Organization (WHO), anemia was defined as serum hemoglobin levels\u0026thinsp;\u0026lt;\u0026thinsp;11.5, \u0026lt;\u0026thinsp;12, and \u0026lt;\u0026thinsp;13 g/dL in children aged 6\u0026ndash;11.99 years, children aged 12\u0026ndash;14.99 years, and male children aged\u0026thinsp;\u0026ge;\u0026thinsp;15 years, respectively. Hypertension was defined as a blood pressure above the 95th percentile or the use of any antihypertensive medication. The primary caregiver was the main person responsible for the patient. Family income was recorded as the total monthly income, with an exchange rate of 35 Thai baht (THB), approximately equivalent to 1 United States dollar (USD).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eStatistical analysis\u003c/h2\u003e \u003cp\u003eDescriptive statistics were used for the general demographic data of the patients. Continuous normally distributed data are presented as the means and standard deviations (SDs), while nonnormally distributed continuous data are presented as medians and interquartile ranges (IQRs). Categorical data are expressed using numbers and percentages. For the comparison of categorical variables, Pearson\u0026rsquo;s chi-square test was utilized. For continuous variables, either one-way ANOVA or the Kruskal‒Wallis test was employed, chosen based on the distribution of the data. A \u003cem\u003ep\u003c/em\u003e value\u0026thinsp;\u0026lt;\u0026thinsp;0.05 was considered to indicate statistical significance.\u003c/p\u003e \u003cp\u003eThe mean differences between self-reported and parent-reported scores were analyzed by paired Student\u0026rsquo;s t tests. The Pearson correlation coefficient (\u003cem\u003er\u003c/em\u003e) was calculated and used to analyze QoL scores between self-reports and parent-reports. Very strong, strong, moderate, weak, and negligible correlations were defined as values of 0.90-1.00, 0.70\u0026ndash;0.89, 0.40\u0026ndash;0.69, 0.10\u0026ndash;0.39, and less than 0.10, respectively [19]. Relationships between factors and PedsQL scores were identified using univariable and multivariable linear regression analyses. Any variables that were either significant in the univariable logistic regression analysis (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.2) or clinically significant were selected as candidates for multivariable linear regression analysis using the enter method. A \u003cem\u003ep\u003c/em\u003e value\u0026thinsp;\u0026lt;\u0026thinsp;0.05 was considered to indicate statistical significance.\u003c/p\u003e \u003cp\u003eAll the statistical calculations were performed using IBM SPSS Statistics version 29 (IBM Corp, Armonk, NY, USA).\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cstrong\u003e\u003cem\u003eDemographic and clinical characteristics\u003c/em\u003e\u003c/strong\u003e \u003cstrong\u003e\u003cem\u003eof patients at\u0026nbsp;different stages of CKD\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePatients aged 2 to 18 years with CKD stages 2-5D, including KT\u0026nbsp;,\u0026nbsp;were screened for eligibility from September 2022 to November 2023. None\u0026nbsp;of the patients\u0026nbsp;met the exclusion criteria; therefore, all 87 patients were included. Both the patients and their parents completed the PedsQL questionnaire.\u003c/p\u003e\n\u003cp\u003eA comparison\u0026nbsp;of demographic and clinical characteristics among\u0026nbsp;patients with\u0026nbsp;different stages of CKD is presented in Table 1. Overall, the mean age was 13.3 (4.1) years,\u0026nbsp;and 57.5% of the patients were male.\u0026nbsp;The common causes\u0026nbsp;of CKD\u0026nbsp;were\u0026nbsp;glomerular disease (28.7%), congenital anomalies of the kidney and urinary tract (CAKUT) (21.8%), and neurogenic bladder (21.8%). Urinary catheters were used in 19 (21.8%) patients due to\u0026nbsp;a\u0026nbsp;neurogenic bladder. The majority of patients (62.1%) were diagnosed with hypertension, and approximately half of the patients met the criteria for anemia. In addition, there were no\u0026nbsp;differences\u0026nbsp;in sex, height, weight,\u0026nbsp;or\u0026nbsp;hypertension among\u0026nbsp;the\u0026nbsp;groups. However, patients in the KT group were older than those in the other groups\u0026nbsp;were\u0026nbsp;(\u003cem\u003ep\u003c/em\u003e=0.02). The majority of\u0026nbsp;patients\u0026nbsp;in the CKD stage 5D and KT groups\u0026nbsp;had\u0026nbsp;glomerular disease, while the causes of CKD in the CKD stages 2-3 and 3-5 groups included both neurogenic bladder and others (\u003cem\u003ep\u003c/em\u003e=0.04). Most patients who used urinary\u0026nbsp;catheters\u0026nbsp;were in the CKD stage 2-3 and stage 3-4 groups (\u003cem\u003ep\u003c/em\u003e=0.005). Patients in the CKD stage 5D and KT groups\u0026nbsp;were treated with\u0026nbsp;a greater number of medications,\u0026nbsp;with\u0026nbsp;a\u0026nbsp;median of 10\u0026nbsp;(7.0, 11.0) (\u003cem\u003ep\u003c/em\u003e\u0026lt;0.001), and patients in the CKD stage 5D group had a\u0026nbsp;greater incidence of anemia than did\u0026nbsp;those in the other groups (\u003cem\u003ep\u003c/em\u003e\u0026lt;0.001).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eSocioeconomic characteristics\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cem\u003eof patients at\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp;different stages of chronic kidney disease\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe socioeconomic\u0026nbsp;characteristics are summarized in Table 2, and there were no differences\u0026nbsp;in\u0026nbsp;socioeconomic characteristics among\u0026nbsp;the\u0026nbsp;groups. The majority of patients received education within the system (80.5%), which included\u0026nbsp;school, college, and university. All of the patients were covered under the universal coverage scheme. Approximately half of\u0026nbsp;the\u0026nbsp;patients (46%) resided in rural communities,\u0026nbsp;with the majority living in their home (77%). Regarding family characteristics, 77% belonged to complete families, with a median of 4.5 (2, 9)\u0026nbsp;family\u0026nbsp;members. The median monthly family income per household was 20,000 (15,000, 40,000) THB or approximately 571 (428, 1,142) USD.\u0026nbsp;The main caregivers were predominantly parents\u0026nbsp;(92.0%),\u0026nbsp;which was consistent\u0026nbsp;across all groups.\u0026nbsp;Most mothers (70.6%) and fathers (81.2%) had\u0026nbsp;a\u0026nbsp;high school\u0026nbsp;education\u0026nbsp;or lower. Additionally, the majority of the parents were employed (82.4%\u0026nbsp;of mothers and\u0026nbsp;95.1%\u0026nbsp;of fathers) and were in good health (73.3%\u0026nbsp;of mothers and\u0026nbsp;68.4%\u0026nbsp;of fathers).\u003cstrong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003ePedsQL scores and the correlation\u0026nbsp;between self-reported and parent-reported\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp;scores among the different CKD stage groups\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTable 3 presents PedsQL\u0026nbsp;score\u0026nbsp;correlations between self-reported scores and parent-reported scores among different the CKD stage groups. The analysis included 83 pairs of reports, excluding patients aged 2-4 years due to exclusive parent-reported responses in this age group. Weak-to-moderate correlations were observed between self-reported and parent-reported total PedsQL scores in\u0026nbsp;the\u0026nbsp;CKD stage 2-3 (\u003cem\u003er\u003c/em\u003e=0.12), stage 4-5 (\u003cem\u003er\u003c/em\u003e=0.42), stage 5D (\u003cem\u003er\u003c/em\u003e=0.41), and KT groups (\u003cem\u003er\u003c/em\u003e=0.42).\u0026nbsp;Additionally,\u0026nbsp;the\u0026nbsp;correlations between self-reported and parent-reported\u0026nbsp;scores on\u0026nbsp;various PedsQL domains ranged from negligible to moderate among\u0026nbsp;the\u0026nbsp;different CKD stage groups (r= -0.76 to 0.53).\u003c/p\u003e\n\u003cp\u003eIn all CKD stage groups and PedsQL domains, parent-reported scores consistently exceeded self-reported scores.\u0026nbsp;Overall, self-reported\u0026nbsp;physical, social, school, and total scores\u0026nbsp;were significantly greater\u0026nbsp;(\u003cem\u003ep\u003c/em\u003e\u0026lt;0.05).\u0026nbsp;In the CKD stage 2-3 group, self-reported scores were significantly\u0026nbsp;greater for emotional\u0026nbsp;functioning (\u003cem\u003ep\u003c/em\u003e\u0026lt;0.05). In the CKD stage 4-5\u0026nbsp;group, self-reported\u0026nbsp;social, school functioning, and total scores\u0026nbsp;were significantly greater\u0026nbsp;(\u003cem\u003ep\u003c/em\u003e\u0026lt;0.05). For CKD stage 5D\u0026nbsp;patients, self-reported\u0026nbsp;scores were significantly\u0026nbsp;greater for\u0026nbsp;all dimensions and the total score (\u003cem\u003ep\u003c/em\u003e\u0026lt;0.05). Similarly, in the KT group, self-reported\u0026nbsp;scores were significantly\u0026nbsp;greater for\u0026nbsp;school functioning (\u003cem\u003ep\u003c/em\u003e\u0026lt;0.05).\u003c/p\u003e\n\u003cp\u003eThe self-reported total scores were 77.5 (12.5), 78.9 (11.2), 77.4 (16.2),\u0026nbsp;and\u0026nbsp;76.1 (10.9) in\u0026nbsp;the\u0026nbsp;CKD stage 2-3, stage 4-5, stage 5D and KT groups, respectively. Parent-reported total scores showed weak-to-moderate correlations with self-reported scores\u0026nbsp;(\u003cem\u003er\u003c/em\u003e=0.12-0.42), with scores\u0026nbsp;of\u0026nbsp;71.8 (12.7), 69.5 (14.9), 63.4 (14.8), and 70.8 (18.1) in\u0026nbsp;the\u0026nbsp;CKD stage 2-3, stage 4-5, stage 5D and KT groups, respectively.\u0026nbsp;While self-reported PedsQL total scores and domain scores did not significantly differ among the CKD stage groups, parent-reported PedsQL scores revealed notable distinctions. According to parent\u0026nbsp;reports, with the CKD stage 5D group consistently had the lowest scores across all domains compared to other groups, but this difference was not statistically significant. For instance,\u0026nbsp;for\u0026nbsp;physical functioning,\u0026nbsp;the\u0026nbsp;parent-reported scores were 63.1 (16.9) for\u0026nbsp;the\u0026nbsp;CKD stage 5D group, 71.9 (18.4) for\u0026nbsp;the\u0026nbsp;CKD stage 2-3 group, 70.1 (24) for\u0026nbsp;the\u0026nbsp;CKD stage 4-5 group, and 70.9 (22.6) for the KT group (\u003cem\u003ep\u003c/em\u003e=0.38).\u0026nbsp;Similar patterns were observed in\u0026nbsp;the\u0026nbsp;emotional (\u003cem\u003ep\u003c/em\u003e=0.54), social (\u003cem\u003ep\u003c/em\u003e=0.40), and school functioning domains (\u003cem\u003ep\u003c/em\u003e=0.15), where the CKD stage 5D group consistently showed the lowest scores among the groups.\u003cstrong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eThe relationships between different factors and self-reported and parent-reported PedsQL scores\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA\u0026nbsp;univariable\u0026nbsp;linear regression analysis was performed to explore the\u0026nbsp;relationships\u0026nbsp;between different factors and PedsQL scores, as presented in Table 4. The univariable linear regression analysis of self-reported\u0026nbsp;scores revealed no statistically significant associations. In contrast, the univariable linear regression analysis of parent-reported\u0026nbsp;scores identified CKD stage 5D (\u003cem\u003e\u0026beta;\u003c/em\u003e:-8.3,\u0026nbsp;95% CI:\u0026nbsp;(-15.93, -0.67, \u003cem\u003ep\u003c/em\u003e=0.03) and a low maternal education level (\u003cem\u003e\u0026beta;\u003c/em\u003e:-8.19, -15.29, -1.08, \u003cem\u003ep\u003c/em\u003e=0.03) as potential factors associated with PedsQL scores.\u0026nbsp;Other\u0026nbsp;risk factors were not statistically significant.\u003c/p\u003e\n\u003cp\u003eA total of 87 patients were included in this study;\u0026nbsp;hence,\u0026nbsp;9 factors could be selected as candidates for the multivariate linear regression analysis model (with 10 patients per factor). The results of the multivariate linear regression analysis (Table 5) for parent reports identified CKD stage (\u003cem\u003ep\u003c/em\u003e=0.03 in CKD stage 5D patients), height \u0026lt;3\u003csup\u003erd\u003c/sup\u003e percentile (\u003cem\u003ep\u003c/em\u003e=0.21, clinically significant), anemia (\u003cem\u003ep\u003c/em\u003e =0.14), number of medications (\u003cem\u003ep\u003c/em\u003e =0.53, clinically significant), leaving school (\u003cem\u003ep\u003c/em\u003e =0.88, clinically significant), not living with parents (\u003cem\u003ep\u003c/em\u003e=0.46, clinically significant), low family income (\u003cem\u003ep\u003c/em\u003e =0.94, clinically significant), a low maternal education level (\u003cem\u003ep\u003c/em\u003e=0.02), and a low paternal education (\u003cem\u003ep\u003c/em\u003e =0.35, clinically significant)\u0026nbsp;as factors for the final model built using the enter method.\u0026nbsp;Notably, CKD stage 5D patients and patients whose mothers had low education levels were significantly associated with PedsQL scores that were 15.92 points (\u003cem\u003ep\u003c/em\u003e=0.02) and 10.13 points (\u003cem\u003ep\u003c/em\u003e=0.04) lower, respectively, than those of patients in the early stages of CKD and whose mothers had high education levels.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study aimed to assess QOL scores in children at different stages of CKD in a developing country and to identify the potential impact of clinical and socioeconomic factors on QoL outcomes. The parent-reported total scores were 71.8 (12.7), 69.5 (14.9), 63.4 (14.8), and 70.8 (18.1) in the CKD stage 2\u0026ndash;3, stage 4\u0026ndash;5, stage 5D and KT groups, respectively. Notably, parent-reported scores consistently lagged behind self-reported scores at all CKD stages, showing a weak-to-moderate correlation (\u003cem\u003er\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.12\u0026ndash;0.42). Additionally, in parent-reported assessments, the score of the CKD stage 5D group was significantly lower than that of the early-stage CKD group (by 15.92 points (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.02)), while the low maternal education group score was 10.13 points lower than that of the high maternal education group (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.04).\u003c/p\u003e \u003cp\u003eThe patients included in this study had clinical characteristics similar to those of the populations of studies on QoL in pediatric patients with CKD, including age, sex, etiology of CKD, and anemia [7\u0026ndash;9, 11, 12] The majority of patients in this study were adolescents with a mean age of 13.3 years, and the common etiologies of CKD were glomerular disease, CAKUT, and neurogenic bladder. The socioeconomic status in this study was lower than those observed in studies conducted in developed countries [8]. In contrast to studies conducted in developed countries where the maternal education level predominantly exceeded high school levels [8], the majority of mothers in this study had a high school education or lower, similar to findings in another study conducted in a developing country [9]. The main caregivers in this study were parents, and most of the children lived with a full family structure, similar to the findings of other studies [7, 9, 11].\u003c/p\u003e \u003cp\u003ePrevious pediatric research has shown that pediatric patients with CKD tend to have lower QoL than healthy children [7\u0026ndash;12]. Similarly, this study reaffirms these observations, demonstrating that pediatric patients at all stages of CKD exhibited reduced QoL when compared to healthy Thai children, as studied by Sritipsukho et al. [20]. Additionally, Lopes et al. [7] demonstrated that individuals with CKD stage 5D had lower total, physical, emotional, and school domain scores than KT patients did. Similarly, this study underscores this disparity, revealing that patients with CKD stage 5D, as reported by parents, had lower QoL scores across all domains than patients in other CKD groups.\u003c/p\u003e \u003cp\u003eIn a previous study [8], no significant difference was found between parent- and self-reported PedsQL scores, with some studies suggesting higher scores from parent-reported assessments than from self-reported assessments [7, 9]. Conversely, other studies indicated lower PedsQL scores in parent-reported assessments than in self-reported assessments [10, 12]. This study supports these findings, demonstrating a lack of correlation between parent-reported and self-reported scores. Parent-reported assessments consistently revealed lower PedsQL scores than self-reported assessments across all stages of CKD and domains, which was particularly notable in patients in advanced stages of CKD (stage 4-5D). This discrepancy may arise because parents often consider the overall well-being of their children, whereas the children themselves may not perceive certain issues from their childlike perspective. Additionally, the heightened caregiving responsibilities undertaken by parents for pediatric patients with CKD, especially in advanced stages, can lead to elevated stress levels and increased financial burdens for caregivers [21].\u003c/p\u003e \u003cp\u003eA multicenter study of adults revealed both physical and mental burdens in patients receiving either peritoneal dialysis or hemodialysis [22]. Similarly, this study demonstrated that patients with CKD stage 5D had significantly lower parent-reported PedsQL scores (by 15.92 points) than patients with CKD in the early stages. One potential explanation is that patients with CKD stage 5 typically undergo complex medication regimens with multiple doses throughout the day, experience physical weakness including failure to thrive, face dietary restrictions, often miss school due to medical appointments or hospital admissions, rely on hemodialysis or peritoneal dialysis machines for treatment, and may experience feelings of depression [2].\u003c/p\u003e \u003cp\u003eIn this study, a significant association was observed between low maternal education levels and parent-reported PedsQL scores: the parent-reported PedsQL score was 10.13 points lower in the low maternal education group than in the high maternal education group. These findings are in line with a previous study by Gerson et al. [8], which identified a relationship between low maternal education levels and QoL in patients with mild to moderate CKD. Moreover, a low maternal education level has been shown to impact children\u0026rsquo;s QoL across various diseases, including thalassemia, cancer, type 1 diabetes mellitus, asthma, and overweight/obesity [23\u0026ndash;25]. One potential explanation is that a lower maternal education level is often correlated with a lower household income level, resulting in limited access to nutritious food, safe housing, and educational opportunities. Additionally, a low maternal education level is often associated with increased stress and limited knowledge and skills to provide support and guidance to children. These factors can collectively impact the QoL of a child. Additional potential factors associated with QoL in patients with CKD, as reported in previous pediatric studies [8], include younger age and short stature. However, these variables were not found to be statistically significant in this study.\u003c/p\u003e \u003cp\u003eThis study has several strengths. First, this study encompassed a relatively large population compared to a previous study conducted in Thailand [10] that utilized the same PedsQL instrument. Second, the population encompassed a wide range of ages, from 2 to 18 years, rather than being limited to a specific age group. Third, the generalizability of this study to all children with CKD in developing countries is notable. While conducted in a tertiary center, approximately half of the patients resided in rural areas and were referred from local hospitals across all regions of Thailand. Fourth, this study examined the relationships between different factors and QoL. Based on a review of the literature, only one previous study conducted in a developed country investigated this variable [8]. This study revealed that CKD stage 5D and low maternal education levels were associated with low QoL, and these results expand on those in the literature. Our study also has several limitations. First, this was a cross-sectional study assessing QoL in patients with CKD. However, QoL is subject to change over time due to various factors, such as alterations in health status, socioeconomic circumstances, and life events. Therefore, a longitudinal analysis could provide more comprehensive information regarding the dynamic nature of QoL in this population. Second, this study employed the PedsQL, relying on information provided by the patients and their parents. As a result, the assessment of school functioning may not be entirely accurate due to the absence of first-hand data during school hours. Therefore, supplementing the data with information obtained from teachers regarding learning issues would contribute to the comprehensiveness of the dataset. Third, there was no comparison of QoL between the patients with CKD and healthy controls in this study. However, our study revealed lower QoL scores in pediatric patients with CKD than in healthy Thai children, as studied by Sritipsukho et al. [20]. Therefore, there is a need for additional prospective longitudinal studies to assess QoL among patients at various stages of CKD while incorporating teacher assessments of school functioning. Additionally, comparing these findings with those of a healthy control group would further validate the outcomes of this study.\u003c/p\u003e \u003cp\u003eIn conclusion, this study demonstrated a significant association between low QoL and CKD stage 5, as well as between low QoL and low maternal education levels. We recommend regular QoL assessment for children with advanced CKD and those at socioeconomic risk.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003e\u003cem\u003eFunding\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was funded by the Research Department, Siriraj Hospital, Faculty of Medicine, Mahidol University, Bangkok, Thailand (grant number (IO) R016531074).\u003cstrong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eCompeting interests\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eEthics approval\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was approved by the Institutional Review Board of Siriraj Hospital.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eConsent to participate\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eInformed assent and consent were obtained from all participants and their parents.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eConsent for publication\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eData Availability\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eCode availability\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eAuthors\u0026rsquo; contribution\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003col\u003e\n \u003cli\u003eUrapee\u0026nbsp;Chaichana recruited participants, collected the data, performed the analysis, interpreted the data, drafted the initial manuscript, and approved the final manuscript\u0026nbsp;for submission.\u003c/li\u003e\n \u003cli\u003eJulaporn Pooliam\u0026nbsp;performed the analysis, interpreted the data and approved the final manuscript\u0026nbsp;for submission.\u003c/li\u003e\n \u003cli\u003eMaturin Jantongsree\u0026nbsp;invited participants, collected the data,\u0026nbsp;assisted with financial documentation and approved the final manuscript\u0026nbsp;for submission.\u003c/li\u003e\n \u003cli\u003eSasithorn Chantaratin\u0026nbsp;interpreted the data, revised the work critically for important intellectual content and approved the final manuscript\u0026nbsp;for submission.\u003c/li\u003e\n \u003cli\u003eAchra Sumboonnanonda\u0026nbsp;interpreted the data, revised the work critically for important intellectual content and approved the final manuscript\u0026nbsp;for submission.\u003c/li\u003e\n \u003cli\u003eAnirut Pattaragarn\u0026nbsp;interpreted the data, revised the work critically for important intellectual content and approved the final manuscript\u0026nbsp;for submission.\u003c/li\u003e\n \u003cli\u003eSuroj Supavekin\u0026nbsp;interpreted the data, revised the work critically for important intellectual content and approved the final manuscript\u0026nbsp;for submission.\u003c/li\u003e\n \u003cli\u003eNuntawan Piyaphanee\u0026nbsp;interpreted the data, revised the work critically for important intellectual content and approved the final manuscript\u0026nbsp;for submission.\u003c/li\u003e\n \u003cli\u003eKraisoon Lomjansook\u0026nbsp;interpreted the data, revised the work critically for important intellectual content and approved the final manuscript\u0026nbsp;for submission.\u003c/li\u003e\n \u003cli\u003eYarnarin Thunsiribuddhicha\u0026nbsp;interpreted the data, revised the work critically for important intellectual content and approved the final manuscript\u0026nbsp;for submission.\u003c/li\u003e\n \u003cli\u003eIntraparch Tinnabut\u0026nbsp;created a form in\u0026nbsp;Excel\u0026nbsp;for calculating QoL scores and approved the final manuscript\u0026nbsp;for submission.\u003c/li\u003e\n \u003cli\u003eThanaporn Chaiyapak made substantial contributions to the conception of the study, designed the study, interpreted the data, revised the work critically for important intellectual content, and approved the final manuscript for submission.\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eGoldstein SL, Graham N, Burwinkle T, Warady B, Farrah R, Varni JW (2006) Health-related quality of life in pediatric patients with ESRD. Pediatr Nephrol 21:846\u0026ndash;850. https://doi.org/10.1007/s00467-006-0081-y\u003c/li\u003e\n \u003cli\u003eGoldstein SL, Gerson AC, Goldman CW, Furth S (2006) Quality of life for children with chronic kidney disease. Semin Nephrol 26:114\u0026ndash;117. https://doi.org/10.1016/j.semnephrol.2005.09.004\u003c/li\u003e\n \u003cli\u003eViriyapak E, Chantaratin S, Sommai K, Sumboonnanonda A, Pattaragarn A, Supavekin S, Piyaphanee N, Lomjansook K, Chaiyapak T (2022) Prevalence of cognitive dysfunction and its risk factors in children with chronic kidney disease in a developing country. Pediatr Nephrol 37:1355\u0026ndash;1364. https://doi.org/10.1007/s00467-021-05280-9\u003c/li\u003e\n \u003cli\u003eClementi MA, Zimmerman CT (2020) Psychosocial considerations and recommendations for care of pediatric patients on dialysis. Pediatr Nephrol 35:767\u0026ndash;775. https://doi.org/10.1007/s00467-019-04227-5\u003c/li\u003e\n \u003cli\u003eGoldstein SL, Gerson AC, Furth S (2007) Health-related quality of life for children with chronic kidney disease. Adv Chronic Kidney Dis 14:364\u0026ndash;369. https://doi.org/10.1053/j.ackd.2007.07.006\u003c/li\u003e\n \u003cli\u003eGoldstein SL, Graham N, Warady BA, Seikaly M, McDonald R, Burwinkle TM, Limbers CA, Varni JW (2008) Measuring health-related quality of life in children with ESRD: performance of the generic and ESRD-specific instrument of the pediatric quality of life inventory (PedsQL). Am J Kidney Dis 51:285\u0026ndash;297. https://doi.org/10.1053/j.ajkd.2007.09.021\u003c/li\u003e\n \u003cli\u003eLopes M, Ferraro A, Koch VH (2014) Health-related quality of life of children and adolescents with CKD stages 4-5 and their caregivers. Pediatr Nephrol 29:1239\u0026ndash;1247. https://doi.org/10.1007/s00467-014-2769-8\u003c/li\u003e\n \u003cli\u003eGerson AC, Wentz A, Abraham AG, Mendley SR, Hooper SR, Butler RW, Gipson DS, Lande MB, Shinnar S, Moxey-Mims MM, Warady BA, Furth SL (2010) Health-related quality of life of children with mild to moderate chronic kidney disease. Pediatrics 125:e349\u0026ndash;e357. https://doi.org/10.1542/peds.2009-0085\u003c/li\u003e\n \u003cli\u003eImani PD, Aujo J, Kiguli S, Srivaths P, Brewer ED (2021) Chronic kidney disease impacts health-related quality of life of children in Uganda, East Africa. Pediatr Nephrol 36:323\u0026ndash;331. https://doi.org/10.1007/s00467-020-04705-1\u003c/li\u003e\n \u003cli\u003eDamri T, Louthrenoo O, Chartapisak W, Opastirakul S (2014) Psychosocial problems and quality of life in children with chronic kidney disease. Biomed Sci Clin Med 53:127\u0026ndash;134.\u003c/li\u003e\n \u003cli\u003eSilva TMC, Alves LAC, Garrido D, Watanabe A, Mendes FM, Ciamponi AL (2019) Health and oral health-related quality of life of children and adolescents with chronic kidney disease: a cross-sectional study. Qual Life Res 28:2481\u0026ndash;2489. https://doi.org/10.1007/s11136-019-02196-8\u003c/li\u003e\n \u003cli\u003eMcKenna AM, Keating LE, Vigneux A, Stevens S, Williams A, Geary DF (2006) Quality of life in children with chronic kidney disease-patient and caregiver assessments. Nephrol Dial Transplant 21:1899\u0026ndash;1905. https://doi.org/10.1093/ndt/gfl091\u003c/li\u003e\n \u003cli\u003eDotis J, Pavlaki A, Printza N, Stabouli S, Antoniou S, Gkogka C, Kontodimopoulos N, Papachristou F (2016) Quality of life in children with chronic kidney disease. Pediatr Nephrol 31:2309\u0026ndash;2316. https://doi.org/10.1007/s00467-016-3457-7\u003c/li\u003e\n \u003cli\u003eBuyan N, T\u0026uuml;rkmen MA, Bilge I et al (2010) Quality of life in children with chronic kidney disease (with child and parent assessments). Pediatr Nephrol 25:1487\u0026ndash;1496. https://doi.org/10.1007/s00467-010-1486-1\u003c/li\u003e\n \u003cli\u003eFrancis A, Didsbury MS, van Zwieten A et al (2019) Quality of life of children and adolescents with chronic kidney disease: a cross-sectional study. Arch Dis Child 104:134\u0026ndash;140. https://doi.org/10.1136/archdischild-2018-314934\u003c/li\u003e\n \u003cli\u003eBaek HS, Kang HG, Choi HJ et al (2017) Health-related quality of life of children with pre-dialysis chronic kidney disease. Pediatr Nephrol 32:2097\u0026ndash;2105. https://doi.org/10.1007/s00467-017-3721-5\u003c/li\u003e\n \u003cli\u003eGroothoff JW (2005) Long-term outcomes of children with end-stage renal disease. Pediatr Nephrol 20:849\u0026ndash;853. https://doi.org/10.1007/s00467-005-1878-9\u003c/li\u003e\n \u003cli\u003eWinterberg PD, Garro R (2019) Long-term outcomes of kidney transplantation in children. Pediatr Clin North Am 66:269\u0026ndash;280. https://doi.org/10.1016/j.pcl.2018.09.008\u003c/li\u003e\n \u003cli\u003eSchober P, Boer C, Schwarte LA (2018) Correlation coefficients: appropriate use and interpretation. Anesth Analg 126:1763\u0026ndash;1768. https://doi.org/10.1213/ane.0000000000002864\u003c/li\u003e\n \u003cli\u003eSritipsukho P, Wisai M, Thavorncharoensap M (2013) Reliability and validity of the Thai version of the Pediatric Quality of Life Inventory 4.0. Qual Life Res 22:551\u0026ndash;557. https://doi.org/10.1007/s11136-012-0190-y\u003c/li\u003e\n \u003cli\u003eWightman A (2020) Caregiver burden in pediatric dialysis. Pediatr Nephrol 35:1575\u0026ndash;1583. https://doi.org/10.1007/s00467-019-04332-5\u003c/li\u003e\n \u003cli\u003eBrown EA, Zhao J, McCullough K, Fuller DS, Figueiredo AE, Bieber B, Finkelstein FO, Shen J, Kanjanabuch T, Kawanishi H, Pisoni RL, Perl J (2021) Burden of kidney disease, health-related quality of life, and employment among patients receiving peritoneal dialysis and in-center hemodialysis: findings from the DOPPS program. Am J Kidney Dis 78:489\u0026ndash;500.e1. https://doi.org/10.1053/j.ajkd.2021.02.327\u003c/li\u003e\n \u003cli\u003eAdam S, Afifi H, Thomas M, Magdy P, El-Kamah G (2017) Quality of life outcomes in a pediatric thalassemia population in egypt. Hemoglobin 41:16\u0026ndash;20. https://doi.org/10.1080/03630269.2017.1312434\u003c/li\u003e\n \u003cli\u003eMota JF, Rezio MA, Soares RC, Pimentel GD, Coelho ASG, Cunha J (2018) Quality of life is influenced by body weight, education, and family income in adolescents with chronic diseases. Biomed Res Int 2018:8485103. https://doi.org/10.1155/2018/8485103\u003c/li\u003e\n \u003cli\u003eCosta D, Cunha M, Ferreira C, Gama A, Machado-Rodrigues AM, Rosado-Marques V, Mendes LL, Nogueira H, Pessoa M, Silva MG, Velasquez-Melendez G, Padez C (2021) Socioeconomic inequalities in children\u0026apos;s health-related quality of life according to weight status. Am J Hum Biol 33:e23453. https://doi.org/10.1002/ajhb.23453\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003e\u003cstrong\u003eTable 1.\u003c/strong\u003e Comparison of demographic and clinical characteristics of patients at different stages of chronic kidney disease\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.25%\" valign=\"top\"\u003e\n \u003cp\u003eCharacteristics\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eCKD stage 2\u0026ndash;3, n (%)\u003cbr\u003e\u0026nbsp;n = 29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eCKD stage 4\u0026ndash;5, n (%)\u003cbr\u003e\u0026nbsp;n = 19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eCKD stage 5D\u003csup\u003ea\u003c/sup\u003e, n (%)\u003cbr\u003e\u0026nbsp;n = 20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003eKidney transplant, n (%)\u003cbr\u003e\u0026nbsp;n = 19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eTotal\u003cbr\u003e\u0026nbsp;n = 87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.25%\" valign=\"top\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e17 (58.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e10 (52.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e12 (60)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e11 (57.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e50 (57.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e0.98\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.25%\" valign=\"top\"\u003e\n \u003cp\u003eAge, years (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e12.3 (4.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e11.9 (3.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e14.0 (4.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e15.4 (1.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e13.3 (4.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.25%\" valign=\"top\"\u003e\n \u003cp\u003eCause of CKD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.25%\" valign=\"top\"\u003e\n \u003cp\u003eGlomerular disease\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e4 (13.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e4 (21.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e9 (45)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e8 (42.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e25 (28.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.25%\" valign=\"top\"\u003e\n \u003cp\u003eCAKUT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e5 (17.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e5 (26.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e6 (30)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e3 (15.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e19 (21.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.25%\" valign=\"top\"\u003e\n \u003cp\u003eNeurogenic bladder\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e9 (31)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e5 (26.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e1 (5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e4 (21.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e19 (21.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.25%\" valign=\"top\"\u003e\n \u003cp\u003eUnknown\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e2 (10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e2 (10.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e4 (4.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.25%\" valign=\"top\"\u003e\n \u003cp\u003eOthers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e11 (37.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e5 (26.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e2 (10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e2 (10.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e20 (23)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.25%\" valign=\"top\"\u003e\n \u003cp\u003eHeight, cm (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e141.0 (23.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e138.8 (17.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e147.8 (20.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e148.5 (14.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e143.7 (19.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e0.30\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.25%\" valign=\"top\"\u003e\n \u003cp\u003eWeight, kg (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e41.8 (20.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e36.4 (12.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e50.7 (29.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e48.1 (12.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e44.0 (20.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e0.12\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.25%\" valign=\"top\"\u003e\n \u003cp\u003eUrinary catheter use\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e9 (31)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e8 (42.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e2 (10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e19 (21.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e0.005\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.25%\" valign=\"top\"\u003e\n \u003cp\u003eNumber of medications, median (IQR)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e2 (0, 4.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e6 (3.0, 8.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e12 (9.3, 15.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e10\u0026nbsp;(7.0, 11.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e7 (0, 21.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt; 0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.25%\" valign=\"top\"\u003e\n \u003cp\u003eHypertension\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e14 (48.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e10 (52.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e17 (85)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e13 (68.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e54 (62.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e0.16\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.25%\" valign=\"top\"\u003e\n \u003cp\u003eAnemia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e9 (31)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e11 (57.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e19 (95)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e10 (52.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e49 (56.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt; 0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eAbbreviations: CAKUT: congenital anomalies of the kidney and urinary tract; CKD: chronic kidney disease; cm: centimeter; D: dialysis; IQR: interquartile range; kg: kilogram; SD: standard deviation.\u003c/p\u003e\n\u003cp\u003eNotes:\u003c/p\u003e\n\u003cp\u003e\u003csup\u003ea\u003c/sup\u003e Including peritoneal dialysis and hemodialysis.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2.\u003c/strong\u003e Comparison of socioeconomic characteristics of patients at different stages of chronic kidney disease\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"97%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.125%\" valign=\"top\"\u003e\n \u003cp\u003eCharacteristics\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003eCKD stage 2\u0026ndash;3, n (%)\u003cbr\u003e\u0026nbsp;n = 29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eCKD stage 4\u0026ndash;5, n (%)\u003cbr\u003e\u0026nbsp;n = 19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eCKD stage 5D\u003csup\u003ea\u003c/sup\u003e, n (%)\u003cbr\u003e\u0026nbsp;n = 20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003eKidney transplant, n (%)\u003cbr\u003e\u0026nbsp;n = 19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003eTotal\u003cbr\u003e\u0026nbsp;n = 87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.125%\" valign=\"top\"\u003e\n \u003cp\u003eType of education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.125%\" valign=\"top\"\u003e\n \u003cp\u003eSchool/college/university\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e25 (86.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e17 (89.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e13 (65)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e15 (78.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e70 (80.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e0.69\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.125%\" valign=\"top\"\u003e\n \u003cp\u003eInformal education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e4 (20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e3 (15.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e7 (8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.125%\" valign=\"top\"\u003e\n \u003cp\u003eChildren who left school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e2 (6.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e2 (10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e3 (15)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e1 (5.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e8 (9.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.125%\" valign=\"top\"\u003e\n \u003cp\u003eUnderage\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e2 (6.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e2 (2.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.125%\" valign=\"top\"\u003e\n \u003cp\u003eUniversal Coverage Scheme\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e29 (100)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e19 (100)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e20 (100)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e19 (100)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e87 (100)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.125%\" valign=\"top\"\u003e\n \u003cp\u003eLives in a rural area\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e11 (37.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e7 (36.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e9 (45)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e13 (68.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e40 (46)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e0.16\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.125%\" valign=\"top\"\u003e\n \u003cp\u003eType of residence\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.125%\" valign=\"top\"\u003e\n \u003cp\u003eHouse/townhouse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e26 (89.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e19 (100)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e20 (100)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e17 (89.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e82 (94.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e0.23\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.125%\" valign=\"top\"\u003e\n \u003cp\u003eApartment/flat/condominium\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e3 (10.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e2 (10.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e5 (5.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.125%\" valign=\"top\"\u003e\n \u003cp\u003eHouse owner\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e21 (72.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e15 (78.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e16 (80)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e15 (78.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e67 (77)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e0.91\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.125%\" valign=\"top\"\u003e\n \u003cp\u003eFamily structure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.125%\" valign=\"top\"\u003e\n \u003cp\u003eFull\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e21 (72.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e15 (78.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e16 (80)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e15 (78.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e67 (77)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e0.65\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.125%\" valign=\"top\"\u003e\n \u003cp\u003eSingle parent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e6 (20.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e4 (21.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e2 (10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e4 (21.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e16 (18.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.125%\" valign=\"top\"\u003e\n \u003cp\u003eNot living with parents\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e1 (3.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e2 (10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e3 (3.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.125%\" valign=\"top\"\u003e\n \u003cp\u003eNumber of family members, (IQR)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e4 (4.0, 6.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e4 (3.0, 4.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e4.5 (4.0, 5.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e4 (3.0, 5.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e4.5 (2.0, 9.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e0.07\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.125%\" valign=\"top\"\u003e\n \u003cp\u003eSiblings\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e21 (72.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e11 (57.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e17 (85)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e10 (52.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e59 (67.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e0.12\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.125%\" valign=\"top\"\u003e\n \u003cp\u003eFamily income, 10,000 THB (IQR)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e2 (1.5, 4.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e2 (1.0, 4.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e2 (1.2, 3.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e2 (1.0, 5.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e2 (1.5, 4.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e0.97\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.125%\" valign=\"top\"\u003e\n \u003cp\u003eMain caregiver\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.125%\" valign=\"top\"\u003e\n \u003cp\u003eParents\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e26 (89.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e17 (89.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e18 (90)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e19 (100)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e80 (92)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e0.55\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.125%\" valign=\"top\"\u003e\n \u003cp\u003eGrandparents/others\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e2 (6.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e1 (5.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e3 (3.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.125%\" valign=\"top\"\u003e\n \u003cp\u003eOthers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e1 (3.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e1 (5.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e2 (10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e4 (4.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.125%\" valign=\"top\"\u003e\n \u003cp\u003eMaternal data (n = 85)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.125%\" valign=\"top\"\u003e\n \u003cp\u003eAge, years (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e42.9 (7.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e39 (7.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e41.3 (6.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e42.8 (7.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e41.7 (7.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e0.31\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.125%\" valign=\"top\"\u003e\n \u003cp\u003eHighest education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.125%\" valign=\"top\"\u003e\n \u003cp\u003eHigh school or lower\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e20 (71.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e14 (73.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e15 (78.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e11 (57.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e60 (70.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e0.49\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.125%\" valign=\"top\"\u003e\n \u003cp\u003eBachelor\u0026rsquo;s degree or higher\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e8 (28.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e5 (26.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e4 (21.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e8 (42.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e25 (29.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.125%\" valign=\"top\"\u003e\n \u003cp\u003eEmployment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e21 (21)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e18 (94.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e15 (75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e16 (84.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e70 (82.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e0.36\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.125%\" valign=\"top\"\u003e\n \u003cp\u003eHealthy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e19 (67.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e15 (78.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e13 (65)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e16 (84.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e63 (73.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e0.46\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.125%\" valign=\"top\"\u003e\n \u003cp\u003ePaternal data (n = 85)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.125%\" valign=\"top\"\u003e\n \u003cp\u003eAge, years (IQR)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e45 (38.3, 49.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e42.5 (40.3, 46.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e44.5 (35.0, 49.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e46 (38.0, 52.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e45 (38.0, 49.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e0.68\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.125%\" valign=\"top\"\u003e\n \u003cp\u003eHighest education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.125%\" valign=\"top\"\u003e\n \u003cp\u003eHigh school or lower\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e25 (89.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e13 (72.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e18 (90)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e13 (68.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e69 (81.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e0.69\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.125%\" valign=\"top\"\u003e\n \u003cp\u003eBachelor\u0026rsquo;s degree or higher\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e3 (10.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e5 (27.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e2 (10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e6 (31.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e16 (18.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.125%\" valign=\"top\"\u003e\n \u003cp\u003eEmployment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e25 (96.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e17 (94.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e19 (95)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e17 (94.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e78 (95.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e0.99\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.125%\" valign=\"top\"\u003e\n \u003cp\u003eHealthy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e18 (69.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e11 (64.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e15 (83.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e10 (55.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\" valign=\"top\"\u003e\n \u003cp\u003e54 (68.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.291666666666667%\" valign=\"top\"\u003e\n \u003cp\u003e0.34\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eAbbreviations: CKD: chronic kidney disease; D: dialysis; IQR: interquartile range; NA: not applicable; THB: thai baht.\u003c/p\u003e\n\u003cp\u003eNotes:\u003c/p\u003e\n\u003cp\u003e\u003csup\u003ea\u003c/sup\u003e Including peritoneal dialysis and hemodialysis.\u003c/p\u003e\n\u003cp\u003e\u003csup\u003eb\u003c/sup\u003e 10,000 THB is equal to approximately 350 United States dollars (USD).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3.\u003c/strong\u003e PedsQL scores and the correlation between self-reported and parent-reported scores among the different CKD stage groups\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"10.309278350515465%\" valign=\"top\"\u003e\n \u003cp\u003eVariables\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.52577319587629%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003eCKD stage 2\u0026ndash;3 (n = 27)\u003cbr\u003emean (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.52577319587629%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003eCKD stage 4\u0026ndash;5 (n = 18)\u003cbr\u003emean (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.52577319587629%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003eCKD stage\u0026nbsp;5D\u003csup\u003ea\u003c/sup\u003e (n = 20)\u003cbr\u003emean (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.556701030927837%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003eKidney transplant (n = 19)\u003cbr\u003emean (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.556701030927837%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003eTotal (n = 84)\u003cbr\u003emean (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"10.869565217391305%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.521739130434782%\" valign=\"top\"\u003e\n \u003cp\u003eSelf-reports\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.608695652173913%\" valign=\"top\"\u003e\n \u003cp\u003eParent-reports\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.260869565217391%\" valign=\"top\"\u003e\n \u003cp\u003er\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.521739130434782%\" valign=\"top\"\u003e\n \u003cp\u003eSelf-reports\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.608695652173913%\" valign=\"top\"\u003e\n \u003cp\u003eParent-reports\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.260869565217391%\" valign=\"top\"\u003e\n \u003cp\u003er\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.521739130434782%\" valign=\"top\"\u003e\n \u003cp\u003eSelf-reports\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.608695652173913%\" valign=\"top\"\u003e\n \u003cp\u003eParent-reports\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.260869565217391%\" valign=\"top\"\u003e\n \u003cp\u003er\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.521739130434782%\" valign=\"top\"\u003e\n \u003cp\u003eSelf-reports\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.695652173913043%\" valign=\"top\"\u003e\n \u003cp\u003eParent-reports\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.260869565217391%\" valign=\"top\"\u003e\n \u003cp\u003er\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.521739130434782%\" valign=\"top\"\u003e\n \u003cp\u003eSelf-report\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.608695652173913%\" valign=\"top\"\u003e\n \u003cp\u003eParent-reports\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.3478260869565215%\" valign=\"top\"\u003e\n \u003cp\u003er\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"10.869565217391305%\" valign=\"top\"\u003e\n \u003cp\u003ePhysical functioning\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.521739130434782%\" valign=\"top\"\u003e\n \u003cp\u003e82.2 (12.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.608695652173913%\" valign=\"top\"\u003e\n \u003cp\u003e71.9 (18.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.260869565217391%\" valign=\"top\"\u003e\n \u003cp\u003e0.31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.521739130434782%\" valign=\"top\"\u003e\n \u003cp\u003e79.9\u0026nbsp;(12.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.608695652173913%\" valign=\"top\"\u003e\n \u003cp\u003e70.1 (21.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.260869565217391%\" valign=\"top\"\u003e\n \u003cp\u003e0.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.521739130434782%\" valign=\"top\"\u003e\n \u003cp\u003e77.3 (15.2)\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.608695652173913%\" valign=\"top\"\u003e\n \u003cp\u003e63.1 (16.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.260869565217391%\" valign=\"top\"\u003e\n \u003cp\u003e0.45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.521739130434782%\" valign=\"top\"\u003e\n \u003cp\u003e75.8 (18.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.695652173913043%\" valign=\"top\"\u003e\n \u003cp\u003e70.9 (22.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.260869565217391%\" valign=\"top\"\u003e\n \u003cp\u003e0.41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.521739130434782%\" valign=\"top\"\u003e\n \u003cp\u003e79.1 (13.6)\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.608695652173913%\" valign=\"top\"\u003e\n \u003cp\u003e69.8 (19.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.3478260869565215%\" valign=\"top\"\u003e\n \u003cp\u003e0.33\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"10.869565217391305%\" valign=\"top\"\u003e\n \u003cp\u003eEmotional functioning\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.521739130434782%\" valign=\"top\"\u003e\n \u003cp\u003e72.8\u0026nbsp;(18.9)\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.608695652173913%\" valign=\"top\"\u003e\n \u003cp\u003e73.5 (14.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.260869565217391%\" valign=\"top\"\u003e\n \u003cp\u003e0.45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.521739130434782%\" valign=\"top\"\u003e\n \u003cp\u003e75.0\u0026nbsp;(15.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.608695652173913%\" valign=\"top\"\u003e\n \u003cp\u003e69.4 (12.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.260869565217391%\" valign=\"top\"\u003e\n \u003cp\u003e0.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.521739130434782%\" valign=\"top\"\u003e\n \u003cp\u003e77.8 (21.9)\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.608695652173913%\" valign=\"top\"\u003e\n \u003cp\u003e66.8 (19.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.260869565217391%\" valign=\"top\"\u003e\n \u003cp\u003e0.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.521739130434782%\" valign=\"top\"\u003e\n \u003cp\u003e74.5 (20.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.695652173913043%\" valign=\"top\"\u003e\n \u003cp\u003e71.6 (20.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.260869565217391%\" valign=\"top\"\u003e\n \u003cp\u003e0.43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.521739130434782%\" valign=\"top\"\u003e\n \u003cp\u003e74.8 (19.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.608695652173913%\" valign=\"top\"\u003e\n \u003cp\u003e71.1 (16.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.3478260869565215%\" valign=\"top\"\u003e\n \u003cp\u003e0.37\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"10.869565217391305%\" valign=\"top\"\u003e\n \u003cp\u003eSocial functioning\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.521739130434782%\" valign=\"top\"\u003e\n \u003cp\u003e83.3\u0026nbsp;(15.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.608695652173913%\" valign=\"top\"\u003e\n \u003cp\u003e77.2 (17.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.260869565217391%\" valign=\"top\"\u003e\n \u003cp\u003e0.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.521739130434782%\" valign=\"top\"\u003e\n \u003cp\u003e87.8\u0026nbsp;(14.3)\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.608695652173913%\" valign=\"top\"\u003e\n \u003cp\u003e73.6 (18.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.260869565217391%\" valign=\"top\"\u003e\n \u003cp\u003e0.46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.521739130434782%\" valign=\"top\"\u003e\n \u003cp\u003e88.0 (17.9)\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.608695652173913%\" valign=\"top\"\u003e\n \u003cp\u003e70.0 (17.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.260869565217391%\" valign=\"top\"\u003e\n \u003cp\u003e0.47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.521739130434782%\" valign=\"top\"\u003e\n \u003cp\u003e79.4\u0026nbsp;(13.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.695652173913043%\" valign=\"top\"\u003e\n \u003cp\u003e79.2\u0026nbsp;(19.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.260869565217391%\" valign=\"top\"\u003e\n \u003cp\u003e0.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.521739130434782%\" valign=\"top\"\u003e\n \u003cp\u003e84.5 (15.7)\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.608695652173913%\" valign=\"top\"\u003e\n \u003cp\u003e75.9\u0026nbsp;(17.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.3478260869565215%\" valign=\"top\"\u003e\n \u003cp\u003e0.27\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"10.869565217391305%\" valign=\"top\"\u003e\n \u003cp\u003eSchool functioning\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.521739130434782%\" valign=\"top\"\u003e\n \u003cp\u003e71.7 \u0026plusmn; 14.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.608695652173913%\" valign=\"top\"\u003e\n \u003cp\u003e64.4 \u0026plusmn; 17.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.260869565217391%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026minus;0.76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.521739130434782%\" valign=\"top\"\u003e\n \u003cp\u003e73.3 (12.7)\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.608695652173913%\" valign=\"top\"\u003e\n \u003cp\u003e65.0 (19.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.260869565217391%\" valign=\"top\"\u003e\n \u003cp\u003e0.53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.521739130434782%\" valign=\"top\"\u003e\n \u003cp\u003e66.5\u0026nbsp;(20.1)\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.608695652173913%\" valign=\"top\"\u003e\n \u003cp\u003e54.2 (20.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.260869565217391%\" valign=\"top\"\u003e\n \u003cp\u003e0.40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.521739130434782%\" valign=\"top\"\u003e\n \u003cp\u003e74.7 (12.6)\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.695652173913043%\" valign=\"top\"\u003e\n \u003cp\u003e61.6\u0026nbsp;(20.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.260869565217391%\" valign=\"top\"\u003e\n \u003cp\u003e0.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.521739130434782%\" valign=\"top\"\u003e\n \u003cp\u003e71.5\u0026nbsp;(15.4)\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.608695652173913%\" valign=\"top\"\u003e\n \u003cp\u003e62.5 (19.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.3478260869565215%\" valign=\"top\"\u003e\n \u003cp\u003e0.24\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"10.869565217391305%\" valign=\"top\"\u003e\n \u003cp\u003eTotal score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.521739130434782%\" valign=\"top\"\u003e\n \u003cp\u003e77.5 \u0026plusmn; 12.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.608695652173913%\" valign=\"top\"\u003e\n \u003cp\u003e71.8 \u0026plusmn; 12.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.260869565217391%\" valign=\"top\"\u003e\n \u003cp\u003e0.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.521739130434782%\" valign=\"top\"\u003e\n \u003cp\u003e78.9\u0026nbsp;(11.2)\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.608695652173913%\" valign=\"top\"\u003e\n \u003cp\u003e69.5\u0026nbsp;(14.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.260869565217391%\" valign=\"top\"\u003e\n \u003cp\u003e0.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.521739130434782%\" valign=\"top\"\u003e\n \u003cp\u003e77.4\u0026nbsp;(16.2)\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.608695652173913%\" valign=\"top\"\u003e\n \u003cp\u003e63.4 (14.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.260869565217391%\" valign=\"top\"\u003e\n \u003cp\u003e0.41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.521739130434782%\" valign=\"top\"\u003e\n \u003cp\u003e76.1 (10.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.695652173913043%\" valign=\"top\"\u003e\n \u003cp\u003e70.8 (18.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"3.260869565217391%\" valign=\"top\"\u003e\n \u003cp\u003e0.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.521739130434782%\" valign=\"top\"\u003e\n \u003cp\u003e77.5 (12.7)\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.608695652173913%\" valign=\"top\"\u003e\n \u003cp\u003e69.8 (15.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.3478260869565215%\" valign=\"top\"\u003e\n \u003cp\u003e0.31\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eAbbreviations: CKD: chronic kidney disease; D: dialysis; PedsQL: pediatric quality of life inventory; SD: standard deviation; \u003cem\u003er\u003c/em\u003e: correlation.\u003c/p\u003e\n\u003cp\u003e\u003csup\u003ea\u003c/sup\u003e Including peritoneal dialysis and hemodialysis.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003csup\u003e*\u003c/sup\u003e Difference between self and parent reports; p \u0026lt; 0.05.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4.\u003c/strong\u003e Univariable linear regression analyses of the relationships between different factors and self- and parent-reported PedsQL scores\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.673469387755105%\" valign=\"top\"\u003e\n \u003cp\u003eCharacteristics\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"34.69387755102041%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eSelf-reported scores\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.632653061224488%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eParent-reported scores\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.673469387755105%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.510204081632654%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026beta; (unstandardized coefficients) (95% CI)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.183673469387756%\" valign=\"top\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.510204081632654%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026beta; (unstandardized coefficients) (95% CI)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.122448979591836%\" valign=\"top\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.673469387755105%\" valign=\"top\"\u003e\n \u003cp\u003eClinical characteristics\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.510204081632654%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.183673469387756%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.510204081632654%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.122448979591836%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.673469387755105%\" valign=\"top\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.510204081632654%\" valign=\"top\"\u003e\n \u003cp\u003e0.49 (\u0026minus;0.27, 1.25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.183673469387756%\" valign=\"top\"\u003e\n \u003cp\u003e0.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.510204081632654%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026minus;0.13 (\u0026minus;0.95, 0.69)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.122448979591836%\" valign=\"top\"\u003e\n \u003cp\u003e0.75\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.673469387755105%\" valign=\"top\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.510204081632654%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026minus;1.38 (\u0026minus;9.12, 2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.183673469387756%\" valign=\"top\"\u003e\n \u003cp\u003e0.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.510204081632654%\" valign=\"top\"\u003e\n \u003cp\u003e0.34 (\u0026minus;6.33, 7.01)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.122448979591836%\" valign=\"top\"\u003e\n \u003cp\u003e0.92\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.673469387755105%\" valign=\"top\"\u003e\n \u003cp\u003eCKD stage\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.510204081632654%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026minus;0.11 (\u0026minus;6.63, 6.41)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.183673469387756%\" valign=\"top\"\u003e\n \u003cp\u003e0.97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.510204081632654%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026minus;8.30 (\u0026minus;15.93, \u0026minus;0.67)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.122448979591836%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.673469387755105%\" valign=\"top\"\u003e\n \u003cp\u003eCKD\u0026nbsp;stage 2\u0026ndash;3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.510204081632654%\" valign=\"top\"\u003e\n \u003cp\u003eReference\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.183673469387756%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.510204081632654%\" valign=\"top\"\u003e\n \u003cp\u003eReference\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.122448979591836%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.673469387755105%\" valign=\"top\"\u003e\n \u003cp\u003eCKD\u0026nbsp;stage 4\u0026ndash;5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.510204081632654%\" valign=\"top\"\u003e\n \u003cp\u003e1.51 (\u0026minus;6.31, 9.32)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.183673469387756%\" valign=\"top\"\u003e\n \u003cp\u003e0.70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.510204081632654%\" valign=\"top\"\u003e\n \u003cp\u003e1.59 (\u0026minus;6.38, 9.57)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.122448979591836%\" valign=\"top\"\u003e\n \u003cp\u003e0.69\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.673469387755105%\" valign=\"top\"\u003e\n \u003cp\u003eCKD\u0026nbsp;stage 5D\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.510204081632654%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026minus;0.09 (\u0026minus;7.67, 7.49)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.183673469387756%\" valign=\"top\"\u003e\n \u003cp\u003e0.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.510204081632654%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026minus;8.3 (\u0026minus;15.93, \u0026minus;0.67)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.122448979591836%\" valign=\"top\"\u003e\n \u003cp\u003e0.03\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.673469387755105%\" valign=\"top\"\u003e\n \u003cp\u003eKidney\u0026nbsp;transplant\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.510204081632654%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026minus;1.36 (\u0026minus;9.06, 6.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.183673469387756%\" valign=\"top\"\u003e\n \u003cp\u003e0.73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.510204081632654%\" valign=\"top\"\u003e\n \u003cp\u003e1.29 (\u0026minus;6.68, 9.28)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.122448979591836%\" valign=\"top\"\u003e\n \u003cp\u003e0.75\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.673469387755105%\" valign=\"top\"\u003e\n \u003cp\u003eHeight \u0026lt; 3\u003csup\u003erd\u003c/sup\u003e percentile\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.510204081632654%\" valign=\"top\"\u003e\n \u003cp\u003e0.93 (\u0026minus;5.58, 7.44)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.183673469387756%\" valign=\"top\"\u003e\n \u003cp\u003e0.78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.510204081632654%\" valign=\"top\"\u003e\n \u003cp\u003e0.15 (\u0026minus;0.09, 0.39)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.122448979591836%\" valign=\"top\"\u003e\n \u003cp\u003e0.21\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.673469387755105%\" valign=\"top\"\u003e\n \u003cp\u003eWeight \u0026lt; 3\u003csup\u003erd\u003c/sup\u003e percentile\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.510204081632654%\" valign=\"top\"\u003e\n \u003cp\u003e1.23 (\u0026minus;6.44, 8.90)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.183673469387756%\" valign=\"top\"\u003e\n \u003cp\u003e0.75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.510204081632654%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026minus;3.49 (\u0026minus;12.71, 5.73)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.122448979591836%\" valign=\"top\"\u003e\n \u003cp\u003e0.45\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.673469387755105%\" valign=\"top\"\u003e\n \u003cp\u003eCause of CKD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.510204081632654%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.183673469387756%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.510204081632654%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.122448979591836%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.673469387755105%\" valign=\"top\"\u003e\n \u003cp\u003eCAKUT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.510204081632654%\" valign=\"top\"\u003e\n \u003cp\u003eReference\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.183673469387756%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.510204081632654%\" valign=\"top\"\u003e\n \u003cp\u003eReference\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.122448979591836%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.673469387755105%\" valign=\"top\"\u003e\n \u003cp\u003eGlomerular disease\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.510204081632654%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026minus;3.42 (\u0026minus;11.33, 4.49)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.183673469387756%\" valign=\"top\"\u003e\n \u003cp\u003e0.39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.510204081632654%\" valign=\"top\"\u003e\n \u003cp\u003e0.80 (\u0026minus;8.24, 9.85)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.122448979591836%\" valign=\"top\"\u003e\n \u003cp\u003e0.86\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.673469387755105%\" valign=\"top\"\u003e\n \u003cp\u003eNeurogenic bladder\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.510204081632654%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026minus;0.48 (\u0026minus;9.14, 8.17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.183673469387756%\" valign=\"top\"\u003e\n \u003cp\u003e0.91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.510204081632654%\" valign=\"top\"\u003e\n \u003cp\u003e9.78 (0.14, 19.42)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.122448979591836%\" valign=\"top\"\u003e\n \u003cp\u003e0.047\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.673469387755105%\" valign=\"top\"\u003e\n \u003cp\u003eUnknown\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.510204081632654%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026minus;0.27 (\u0026minus;8.25, 7.71)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.183673469387756%\" valign=\"top\"\u003e\n \u003cp\u003e0.95\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.510204081632654%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026minus;2.87 (\u0026minus;11.99, 6.26)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.122448979591836%\" valign=\"top\"\u003e\n \u003cp\u003e0.53\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.673469387755105%\" valign=\"top\"\u003e\n \u003cp\u003eUrinary catheter use\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.510204081632654%\" valign=\"top\"\u003e\n \u003cp\u003e3.38 (\u0026minus;3.49, 10.25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.183673469387756%\" valign=\"top\"\u003e\n \u003cp\u003e0.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.510204081632654%\" valign=\"top\"\u003e\n \u003cp\u003e4.33 (\u0026minus;3.59, 12.26)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.122448979591836%\" valign=\"top\"\u003e\n \u003cp\u003e0.28\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.673469387755105%\" valign=\"top\"\u003e\n \u003cp\u003eNumber of medications\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.510204081632654%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026minus;0.23 (0.57, 5.20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.183673469387756%\" valign=\"top\"\u003e\n \u003cp\u003e0.93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.510204081632654%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026minus;0.21 (\u0026minus;0.86, 0.45)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.122448979591836%\" valign=\"top\"\u003e\n \u003cp\u003e0.53\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.673469387755105%\" valign=\"top\"\u003e\n \u003cp\u003eHypertension\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.510204081632654%\" valign=\"top\"\u003e\n \u003cp\u003e0.67 (\u0026minus;4.81, 6.18)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.183673469387756%\" valign=\"top\"\u003e\n \u003cp\u003e0.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.510204081632654%\" valign=\"top\"\u003e\n \u003cp\u003e0.81 (\u0026minus;5.75, 7.38)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.122448979591836%\" valign=\"top\"\u003e\n \u003cp\u003e0.81\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.673469387755105%\" valign=\"top\"\u003e\n \u003cp\u003eAnemia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.510204081632654%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026minus;0.76 (\u0026minus;6.39, 4.87)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.183673469387756%\" valign=\"top\"\u003e\n \u003cp\u003e0.79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.510204081632654%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026minus;4.90 (\u0026minus;11.46, 1.67)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.122448979591836%\" valign=\"top\"\u003e\n \u003cp\u003e0.14\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.673469387755105%\" valign=\"top\"\u003e\n \u003cp\u003eSocioeconomic characteristics\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.510204081632654%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.183673469387756%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.510204081632654%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.122448979591836%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.673469387755105%\" valign=\"top\"\u003e\n \u003cp\u003eChildren who left school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.510204081632654%\" valign=\"top\"\u003e\n \u003cp\u003e4.31 (\u0026minus;5.69, 14.31)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.183673469387756%\" valign=\"top\"\u003e\n \u003cp\u003e0.39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.510204081632654%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026minus;0.90 (\u0026minus;12.31, 10.52)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.122448979591836%\" valign=\"top\"\u003e\n \u003cp\u003e0.88\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.673469387755105%\" valign=\"top\"\u003e\n \u003cp\u003eLive in rural area\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.510204081632654%\" valign=\"top\"\u003e\n \u003cp\u003e1.70 (\u0026minus;3.86, 7.25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.183673469387756%\" valign=\"top\"\u003e\n \u003cp\u003e0.55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.510204081632654%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026minus;2.69 (\u0026minus;9.28, 3.90)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.122448979591836%\" valign=\"top\"\u003e\n \u003cp\u003e0.42\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.673469387755105%\" valign=\"top\"\u003e\n \u003cp\u003eNot living with parents\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.510204081632654%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026minus;1.37 (\u0026minus;17.45, 14.72)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.183673469387756%\" valign=\"top\"\u003e\n \u003cp\u003e0.87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.510204081632654%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026minus;11.30 (\u0026minus;11.68, 5.37)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.122448979591836%\" valign=\"top\"\u003e\n \u003cp\u003e0.46\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.673469387755105%\" valign=\"top\"\u003e\n \u003cp\u003eNumber of family members\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.510204081632654%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026minus;0.17 (\u0026minus;2.01, 1.69)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.183673469387756%\" valign=\"top\"\u003e\n \u003cp\u003e0.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.510204081632654%\" valign=\"top\"\u003e\n \u003cp\u003e0.29 (\u0026minus;1.95, 2.52)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.122448979591836%\" valign=\"top\"\u003e\n \u003cp\u003e0.80\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.673469387755105%\" valign=\"top\"\u003e\n \u003cp\u003eFamily income \u0026gt; 10,000 THBb\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.510204081632654%\" valign=\"top\"\u003e\n \u003cp\u003e1.07 (\u0026minus;7.15, 9.29)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.183673469387756%\" valign=\"top\"\u003e\n \u003cp\u003e0.80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.510204081632654%\" valign=\"top\"\u003e\n \u003cp\u003e0.38 (\u0026minus;10.30, 9.55)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.122448979591836%\" valign=\"top\"\u003e\n \u003cp\u003e0.94\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.673469387755105%\" valign=\"top\"\u003e\n \u003cp\u003eMaternal education level: high school or less\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.510204081632654%\" valign=\"top\"\u003e\n \u003cp\u003e2.41 (\u0026minus;3.77, 8.59)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.183673469387756%\" valign=\"top\"\u003e\n \u003cp\u003e0.44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.510204081632654%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026minus;8.19 (\u0026minus;15.29, \u0026minus;1.08)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.122448979591836%\" valign=\"top\"\u003e\n \u003cp\u003e0.03\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.673469387755105%\" valign=\"top\"\u003e\n \u003cp\u003ePaternal education level: high school or less\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.510204081632654%\" valign=\"top\"\u003e\n \u003cp\u003e5.73 (\u0026minus;1.45, 12.92)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.183673469387756%\" valign=\"top\"\u003e\n \u003cp\u003e0.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.510204081632654%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026minus;4.02 (\u0026minus;12.49, 4.46)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.122448979591836%\" valign=\"top\"\u003e\n \u003cp\u003e0.35\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.673469387755105%\" valign=\"top\"\u003e\n \u003cp\u003eMain caregiver not parents; grandparents\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.510204081632654%\" valign=\"top\"\u003e\n \u003cp\u003e1.65 (\u0026minus;8.39, 11.69)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.183673469387756%\" valign=\"top\"\u003e\n \u003cp\u003e0.74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.510204081632654%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026minus;0.67 (\u0026minus;12.80, 11.44)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.122448979591836%\" valign=\"top\"\u003e\n \u003cp\u003e0.91\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eAbbreviations: 95% CI: 95% confidence interval; CKD: chronic kidney disease; D: dialysis; PedsQL: pediatric quality of life inventory; THB: thai baht; \u0026beta;: unstandardized coefficients.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eNotes:\u003c/p\u003e\n\u003cp\u003e\u003csup\u003ea\u003c/sup\u003e Including peritoneal dialysis and hemodialysis.\u003c/p\u003e\n\u003cp\u003e\u003csup\u003eb\u003c/sup\u003e 10,000 THB is equal to approximately 350 United States dollars (USD).\u003c/p\u003e\n\u003cp\u003eThe \u0026beta; coefficient indicates the difference in the domain z score per 1-point increase in the PedsQL score.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 5.\u003c/strong\u003e Multivariable linear regression analyses of the relationships between different factors and self- and parent-reported PedsQL scores\u003c/p\u003e\n\u003cdiv align=\"center\"\u003e\n \u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.19191919191919%\" valign=\"top\"\u003e\n \u003cp\u003eCharacteristics\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"40.4040404040404%\" colspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003eChild self-report\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"40.4040404040404%\" colspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003eParent report\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.387755102040817%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.367346938775512%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eUnivariate linear regression analysis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.428571428571427%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eMultivariate linear regression analysis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.408163265306122%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eUnivariate linear regression analysis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.408163265306122%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eMultivariate linear regression analysis\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.587628865979383%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.34020618556701%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026beta; (unstandardized coefficients) (95% CI)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.216494845360825%\" valign=\"top\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.371134020618557%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026beta; (unstandardized coefficients) (95% CI)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.278350515463918%\" valign=\"top\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.371134020618557%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026beta; (unstandardized coefficients) (95% CI)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\" valign=\"top\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.34020618556701%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026beta; (unstandardized coefficients) (95% CI)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\" valign=\"top\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.587628865979383%\" valign=\"top\"\u003e\n \u003cp\u003eCKD stage\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.34020618556701%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.216494845360825%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.371134020618557%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.278350515463918%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.371134020618557%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.34020618556701%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.587628865979383%\" valign=\"top\"\u003e\n \u003cp\u003eCKD stage 4\u0026ndash;5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.34020618556701%\" valign=\"top\"\u003e\n \u003cp\u003e1.51 (\u0026minus;6.31, 9.32)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.216494845360825%\" valign=\"top\"\u003e\n \u003cp\u003e0.70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.371134020618557%\" valign=\"top\"\u003e\n \u003cp\u003e2.97 (\u0026minus;6.66, 12.60)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.278350515463918%\" valign=\"top\"\u003e\n \u003cp\u003e0.54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.371134020618557%\" valign=\"top\"\u003e\n \u003cp\u003e1.59 (\u0026minus;6.38, 9.57)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\" valign=\"top\"\u003e\n \u003cp\u003e0.69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.34020618556701%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026minus;3.64 (\u0026minus;13.98, 6.70)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\" valign=\"top\"\u003e\n \u003cp\u003e0.49\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.587628865979383%\" valign=\"top\"\u003e\n \u003cp\u003eCKD stage 5D\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.34020618556701%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026minus;0.09 (\u0026minus;7.67, 7.49)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.216494845360825%\" valign=\"top\"\u003e\n \u003cp\u003e0.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.371134020618557%\" valign=\"top\"\u003e\n \u003cp\u003e0.97 (\u0026minus;11.32, 13.25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.278350515463918%\" valign=\"top\"\u003e\n \u003cp\u003e0.88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.371134020618557%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026minus;8.3 (\u0026minus;15.93, \u0026minus;0.67)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\" valign=\"top\"\u003e\n \u003cp\u003e0.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.34020618556701%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026minus;15.92 (\u0026minus;29.42, \u0026minus;2.43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\" valign=\"top\"\u003e\n \u003cp\u003e0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.587628865979383%\" valign=\"top\"\u003e\n \u003cp\u003eKidney transplant\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.34020618556701%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026minus;1.36 (\u0026minus;9.06, 6.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.216494845360825%\" valign=\"top\"\u003e\n \u003cp\u003e0.73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.371134020618557%\" valign=\"top\"\u003e\n \u003cp\u003e0.54 (\u0026minus;10.84, 11.91)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.278350515463918%\" valign=\"top\"\u003e\n \u003cp\u003e0.93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.371134020618557%\" valign=\"top\"\u003e\n \u003cp\u003e1.29 (\u0026minus;6.68, 9.28)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\" valign=\"top\"\u003e\n \u003cp\u003e0.75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.34020618556701%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026minus;10.89 (\u0026minus;23.42, 1.64)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\" valign=\"top\"\u003e\n \u003cp\u003e0.09\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.587628865979383%\" valign=\"top\"\u003e\n \u003cp\u003eHeight \u0026lt; 3\u003csup\u003erd\u003c/sup\u003e percentile\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.34020618556701%\" valign=\"top\"\u003e\n \u003cp\u003e0.93 (\u0026minus;5.58, 7.44)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.216494845360825%\" valign=\"top\"\u003e\n \u003cp\u003e0.78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.371134020618557%\" valign=\"top\"\u003e\n \u003cp\u003e0.63 (\u0026minus;7.50, 8.75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.278350515463918%\" valign=\"top\"\u003e\n \u003cp\u003e0.88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.371134020618557%\" valign=\"top\"\u003e\n \u003cp\u003e0.15 (\u0026minus;0.09, 0.39)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\" valign=\"top\"\u003e\n \u003cp\u003e0.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.34020618556701%\" valign=\"top\"\u003e\n \u003cp\u003e8.14 (\u0026minus;0.90, 17.17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\" valign=\"top\"\u003e\n \u003cp\u003e0.08\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.587628865979383%\" valign=\"top\"\u003e\n \u003cp\u003eAnemia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.34020618556701%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026minus;0.76 (\u0026minus;6.39, 4.87)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.216494845360825%\" valign=\"top\"\u003e\n \u003cp\u003e0.79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.371134020618557%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026minus;1.11 (\u0026minus;8.59, 6.37)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.278350515463918%\" valign=\"top\"\u003e\n \u003cp\u003e0.77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.371134020618557%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026minus;4.90 (\u0026minus;11.46, 1.67)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\" valign=\"top\"\u003e\n \u003cp\u003e0.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.34020618556701%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026minus;3.00 (\u0026minus;11.18, 5.19)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\" valign=\"top\"\u003e\n \u003cp\u003e0.47\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.587628865979383%\" valign=\"top\"\u003e\n \u003cp\u003eNumber of medications\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.34020618556701%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026minus;0.23 (\u0026minus;0.57, 0.53)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.216494845360825%\" valign=\"top\"\u003e\n \u003cp\u003e0.93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.371134020618557%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026minus;0.01 (\u0026minus;0.93, 0.91)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.278350515463918%\" valign=\"top\"\u003e\n \u003cp\u003e0.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.371134020618557%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026minus;2.06 (\u0026minus;0.86, 0.45)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\" valign=\"top\"\u003e\n \u003cp\u003e0.53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.34020618556701%\" valign=\"top\"\u003e\n \u003cp\u003e0.77 (\u0026minus;0.25, 1.78)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\" valign=\"top\"\u003e\n \u003cp\u003e0.14\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.587628865979383%\" valign=\"top\"\u003e\n \u003cp\u003eChildren who left school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.34020618556701%\" valign=\"top\"\u003e\n \u003cp\u003e4.31 (\u0026minus;5.69, 14.31)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.216494845360825%\" valign=\"top\"\u003e\n \u003cp\u003e0.39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.371134020618557%\" valign=\"top\"\u003e\n \u003cp\u003e3.50 (\u0026minus;8.49, 15.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.278350515463918%\" valign=\"top\"\u003e\n \u003cp\u003e0.56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.371134020618557%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026minus;0.90 (\u0026minus;12.31, 10.52)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\" valign=\"top\"\u003e\n \u003cp\u003e0.88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.34020618556701%\" valign=\"top\"\u003e\n \u003cp\u003e2.26 (\u0026minus;9.85, 14.38)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\" valign=\"top\"\u003e\n \u003cp\u003e0.71\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.587628865979383%\" valign=\"top\"\u003e\n \u003cp\u003eNot living with parents\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.34020618556701%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026minus;1.37 (\u0026minus;17.45, 14.72)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.216494845360825%\" valign=\"top\"\u003e\n \u003cp\u003e0.87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.371134020618557%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026minus;4.91 (\u0026minus;25.19, 15.37)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.278350515463918%\" valign=\"top\"\u003e\n \u003cp\u003e0.63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.371134020618557%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026minus;11.30 (\u0026minus;11.68, 5.37)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\" valign=\"top\"\u003e\n \u003cp\u003e0.46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.34020618556701%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026minus;8.94 (\u0026minus;31.47, 13.59)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\" valign=\"top\"\u003e\n \u003cp\u003e0.43\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.587628865979383%\" valign=\"top\"\u003e\n \u003cp\u003eFamily income (\u0026lt; 10,000 THB)\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.34020618556701%\" valign=\"top\"\u003e\n \u003cp\u003e1.07 (\u0026minus;7.15, 9.29)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.216494845360825%\" valign=\"top\"\u003e\n \u003cp\u003e0.80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.371134020618557%\" valign=\"top\"\u003e\n \u003cp\u003e1.45 (\u0026minus;8.74, 11.64)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.278350515463918%\" valign=\"top\"\u003e\n \u003cp\u003e0.78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.371134020618557%\" valign=\"top\"\u003e\n \u003cp\u003e0.38 (\u0026minus;9.55, 10.30)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\" valign=\"top\"\u003e\n \u003cp\u003e0.94\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.34020618556701%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026minus;9.79 (\u0026minus;21.10, 1.51)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\" valign=\"top\"\u003e\n \u003cp\u003e0.09\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.587628865979383%\" valign=\"top\"\u003e\n \u003cp\u003eMaternal education level: high school or less\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.34020618556701%\" valign=\"top\"\u003e\n \u003cp\u003e2.41 (\u0026minus;3.77, 8.59)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.216494845360825%\" valign=\"top\"\u003e\n \u003cp\u003e0.44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.371134020618557%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026minus;0.86 (\u0026minus;9.54, 7.82)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.278350515463918%\" valign=\"top\"\u003e\n \u003cp\u003e0.84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.371134020618557%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026minus;8.19 (\u0026minus;15.29, \u0026minus;1.08)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\" valign=\"top\"\u003e\n \u003cp\u003e0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.34020618556701%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026minus;10.13 (\u0026minus;19.66, \u0026minus;0.60)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\" valign=\"top\"\u003e\n \u003cp\u003e0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.587628865979383%\" valign=\"top\"\u003e\n \u003cp\u003ePaternal education level: high school or less\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.34020618556701%\" valign=\"top\"\u003e\n \u003cp\u003e5.73 (\u0026minus;1.45, 12.92)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.216494845360825%\" valign=\"top\"\u003e\n \u003cp\u003e0.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.371134020618557%\" valign=\"top\"\u003e\n \u003cp\u003e6.69 (\u0026minus;3.20, 16.58)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.278350515463918%\" valign=\"top\"\u003e\n \u003cp\u003e0.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.371134020618557%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026minus;4.02 (\u0026minus;12.49, 4.46)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\" valign=\"top\"\u003e\n \u003cp\u003e0.35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.34020618556701%\" valign=\"top\"\u003e\n \u003cp\u003e1.61 (\u0026minus;9.31, 12.53)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.24742268041237%\" valign=\"top\"\u003e\n \u003cp\u003e0.77\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eAbbreviations: 95% CI: 95% confidence interval; CKD: chronic kidney disease; D: dialysis; PedsQL: pediatric quality of life inventory; THB: thai baht; \u0026beta;: unstandardized coefficients.\u003c/p\u003e\n\u003cp\u003eNotes:\u003c/p\u003e\n\u003cp\u003e\u003csup\u003ea\u003c/sup\u003e Including peritoneal dialysis and hemodialysis.\u003c/p\u003e\n\u003cp\u003e\u003csup\u003eb\u003c/sup\u003e 10,000 THB is equal to approximately 290 United States dollars (USD).\u003c/p\u003e\n\u003cp\u003eThe \u0026beta; coefficient indicates the difference in the domain z score per 1-point increase in the PedsQL score.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":true,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"pediatric-nephrology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pnep","sideBox":"Learn more about [Pediatric Nephrology](http://link.springer.com/journal/467)","snPcode":"467","submissionUrl":"https://www.editorialmanager.com/pnep/default2.aspx","title":"Pediatric Nephrology","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false},"keywords":"Chronic kidney disease, quality of life, pediatrics, PedsQL","lastPublishedDoi":"10.21203/rs.3.rs-4055574/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4055574/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground: \u003c/strong\u003eChildren with chronic kidney disease (CKD) require comprehensive assessments, including medical and quality of life (QoL) evaluations. Few studies have been conducted in developing countries.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods: \u003c/strong\u003eThis cross-sectional study included 2–18-year-old patients who were categorized into 4 groups: the CKD stage 2–3, stage 4–5, stage 5 with dialysis (D), and kidney transplantation (KT) groups. QoL was measured using the Pediatric Quality of Life Inventory\u003csup\u003eTM\u003c/sup\u003e (PedsQL\u003csup\u003eTM\u003c/sup\u003e) version 4.0; relationships between different factors and QoL were determined using multivariable linear regression analysis.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults: \u003c/strong\u003eEighty-seven patients (mean age: 13.3 (4.1) years) were included. The self-reported total scores were 77.5 (12.5), 78.9 (11.2), 77.4 (16.2), and 76.1 (10.9) in the stage 2-3, stage 4-5, stage 5D and KT groups, respectively. Parent-reported scores showed a weak-to-moderate correlation with self-reported scores (\u003cem\u003er\u003c/em\u003e=0.12-0.42), with total scores of 71.8 (12.7), 69.5 (14.9), 63.4 (14.8), and 70.8 (18.1) in the stage 2-3, 4-5, 5D and KT groups, respectively. Multivariable linear regression revealed that the parent-reported score in the stage 5D group was 15.92 points lower than that in the early CKD stage group (\u003cem\u003ep\u003c/em\u003e=0.02); the score in the low maternal education group was 10.13 points lower than that in the high maternal education group (\u003cem\u003ep\u003c/em\u003e=0.04).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions: \u003c/strong\u003eParent-reported scores showed weak-to-moderate correlation with self-reported scores.\u003cstrong\u003e \u003c/strong\u003eCKD stage 5D patients and patients with low maternal education had lower QoL. Regular QoL assessment is recommended for advanced CKD patients and patients with socioeconomic vulnerabilities.\u003c/p\u003e","manuscriptTitle":"Quality of Life in Children at Different Stages of Chronic Kidney Disease in a Developing Country","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-03-14 07:19:33","doi":"10.21203/rs.3.rs-4055574/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewerAgreed","content":"","date":"2024-03-13T07:20:50+00:00","index":0,"fulltext":""},{"type":"reviewersInvited","content":"","date":"2024-03-12T17:54:41+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-03-11T08:34:37+00:00","index":"","fulltext":""},{"type":"submitted","content":"Pediatric Nephrology","date":"2024-03-09T06:46:23+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"pediatric-nephrology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pnep","sideBox":"Learn more about [Pediatric Nephrology](http://link.springer.com/journal/467)","snPcode":"467","submissionUrl":"https://www.editorialmanager.com/pnep/default2.aspx","title":"Pediatric Nephrology","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"60c1cdc8-e923-4b83-98f8-ce8cb423f233","owner":[],"postedDate":"March 14th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2024-08-12T16:09:14+00:00","versionOfRecord":{"articleIdentity":"rs-4055574","link":"https://doi.org/10.1007/s00467-024-06442-1","journal":{"identity":"pediatric-nephrology","isVorOnly":false,"title":"Pediatric Nephrology"},"publishedOn":"2024-08-10 15:57:39","publishedOnDateReadable":"August 10th, 2024"},"versionCreatedAt":"2024-03-14 07:19:33","video":"","vorDoi":"10.1007/s00467-024-06442-1","vorDoiUrl":"https://doi.org/10.1007/s00467-024-06442-1","workflowStages":[]},"version":"v1","identity":"rs-4055574","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4055574","identity":"rs-4055574","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}