A longitudinal examination of parent-reported emotional-behavioral functioning of children with mild to moderate chronic kidney disease

Rebecca J. Johnson, Arlene C. Gerson, Lyndsay A. Harshman, Matthew B. Matheson, Shlomo Shinnar, Marc B. Lande, Amy Kogon, Debbie S. Gipson, Bradley A. Warady, Susan L. Furth, Stephen R. Hooper

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Background: Children with mild to moderate chronic kidney disease (CKD) are at increased risk for deficits in neurocognition. Less is known about how CKD affects emotional-behavioral functioning in this population. Methods: Parent ratings of emotional-behavioral functioning at baseline and over time were examined for 845 children with mild to moderate CKD using the Behavior Assessment System for Children, Second Edition Parent Rating Scales (BASC-2 PRS). Associations with demographic and disease-related predictors were also examined. Results: Children with mild to moderate CKD had parent-reported emotional-behavioral functioning largely within normal limits, at baseline and over time. The proportion with T-scores at least 1 SD above the mean was 24% for Internalizing Problems and 28% for Attention Problems. A greater proportion of participants scored lower than expected (worse) on scales measuring adaptive skills (25%). Persistent hypertension predicted attention problems (β = 1.59, 95% CI = 0.24 to 2.94, p < 0.02) and suggested worse behavioral symptoms (β = 1.36, 95% CI = − 0.01 to 2.73, p = 0.05). Participants with proteinuria at baseline, but not at follow-up, had fewer attention problems than participants whose proteinuria had not resolved (β = − 3.48, CI = − 6.79 to − 0.17, p < 0.04). Glomerular diagnosis was related to fewer (β = − 2.68, 95% CI = − 4.93 to − 0.42, p < 0.02) internalizing problems. Conclusions: Although children with CKD generally have average emotional-behavioral parent ratings, a notable percentage of the population may be at risk for problems with attention and adaptive behavior. Providers working with this population should facilitate psychosocial referrals when indicated.

Original languageEnglish (US)
Pages (from-to)1287-1295
Number of pages9
JournalPediatric Nephrology
Issue number7
StatePublished - Jul 1 2020


  • Adaptive behavior
  • BASC-2
  • CKD
  • CKiD
  • Emotional-behavioral
  • Pediatric chronic kidney disease

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Nephrology


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