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Parental health literacy and progression of chronic kidney disease in children

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Abstract

Background

Limited health literacy has been associated with adverse outcomes in children. We evaluated this association in the setting of chronic kidney disease (CKD).

Methods

We assessed the parental health literacy of 367 children enrolled in the Chronic Kidney Disease in Children (CKiD) Study, using the Short Test of Functional Health Literacy (STOFHLA). We evaluated the association between parental health literacy and CKD progression, defined as time to the composite event of renal replacement therapy (RRT, dialysis, or kidney transplant) or 50% decline in estimated glomerular filtration rate (eGFR).

Results

Median CKiD participant age was 9.5 years, 63% were male, and 59% non-Hispanic white. Median eGFR at baseline was 63 ml/min/1.73 m2, and median urine protein-to-creatinine ratio was 0.22. The median STOFHLA score was 98. Over a median follow-up of 3.7 years, the overall CKD progression rate was 2.8 per 100 person-years. After adjustment for demographic and clinical factors, the relative time to CKD progression was 28% longer per 1 SD increase in STOFHLA score (relative time, 95% CI, 1.28, 1.06–1.53).

Conclusions

In this cohort of children with CKD, higher parental health literacy was associated with a nearly 30% longer time to the composite CKD progression outcome.

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Funding

The CKiD Cohort Study was supported by the funding provided by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), the Eunice Kennedy Shriver National Institute of Child Health and Human Development, and the National Heart, Lung, and Blood Institute (U01-DK-66143, U01-DK-66174, U01-DK-082194, U01-DK-66116). Dr. Ricardo is funded by the NIDDK K23-DK-094829 Award. Dr. Lash is funded by the NIDDK K24-DK-092290 Award.

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Authors and Affiliations

  1. Division of Nephrology, University of Illinois, 820 South Wood Street, 418W CSN, MC 793, Chicago, IL, 60612, USA

    Ana C. Ricardo, Vivien Goh, Amatur Amarah & James P. Lash

  2. Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    Lynn N. Pereira & Aisha Betoko

  3. Children’s Mercy, Kansas City, MO, USA

    Bradley A. Warady

  4. National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA

    Marva Moxey-Mims

  5. Division of Nephrology, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Susan Furth

Authors
  1. Ana C. Ricardo
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  2. Lynn N. Pereira
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  3. Aisha Betoko
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  4. Vivien Goh
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  5. Amatur Amarah
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  6. Bradley A. Warady
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  7. Marva Moxey-Mims
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  8. Susan Furth
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  9. James P. Lash
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on behalf of the Chronic Kidney Disease in Children (CKiD) Cohort Investigators

Corresponding author

Correspondence to Ana C. Ricardo.

Ethics declarations

The study protocol was approved by the Institutional Review Boards at all participating sites and all participants gave written informed consent and/or assent.

Conflict of interest

The authors declare that they have no conflict of interest.

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Ricardo, A.C., Pereira, L.N., Betoko, A. et al. Parental health literacy and progression of chronic kidney disease in children. Pediatr Nephrol 33, 1759–1764 (2018). https://doi.org/10.1007/s00467-018-3962-y

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  • DOI: https://doi.org/10.1007/s00467-018-3962-y

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