الفهرس 
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Abstract
Chronic renal failure has emerged as a serious public health problem.
The incidence of the CRF in children has steadily increased, with poor and
ethnic minority children disproportionately affected .
CKD is characterized by an irreversible deterioration of renal function
that gradually progresses to ESRD.
The estimation of HRQOL in children and adolescents has received
increasing attention in pediatrics and adolescent health care, and several
instruments/questionnaires are now available for use in these populations .
The optimal care and proper assessment of the health of children with
CKD can be achieved if the personal perception of the state of their h ealth is
also taken into account .
Goldstein et al in 2008, developed the PedsQL TM questionnaire to
specifically assess QOL in children and adolescents with CKD. This
questionnaire assesses seven domains (general fatigue, kidney disease,
treatment, interaction with family and friends, worry, physical
appearance, and communication), and is applied to patients with CKD
and their parents or guardians .
The aim of the study was to assess the HRQOL in children with CKD
on MHD in the pediatric HD unit of Menoufia university hospital to determine
factors affecting HRQOL in these children.
Thirty five children aging 2 to 18 years with CKD with GFR < 10 ml/
min/1.73 m2 on maintenance hemodialysis treatment were enrolled in this study.
All of them were subjected to full history taking, complete physical
examination, routine lab investigations like CBC, Blood urea nitrogen and
Serum creatinine ( before and after dialysis), serum electrolytes (K+, Ca++ and
PO4), albumin and cholesterol.
All the patients were also subjected to the PedsQL TM questionnaire
ESRD Module. It consists of 34 questions grouped into seven items
comprising health-related perception in the areas of general fatigue,
kidney disease, treatment, interaction with family and friends, worry,
physical appearance, and communication.
Our results revealed that about QOL of our patients. Regarding total
score of QOL , the mean score was 50.48. The best scores in our study were in
the domains of ”communication” and ”family and peer interaction’’ .
Two factors affect the total score of QOL: Gender and Age. Males had
better QOL than females as the mean total score was 69.84 while for females
was 61.37 which was statistically significant. Also age affect total score of
QOL as the sub group 8- <13 years had better QOL than others with the mean
score was 69. 6 with significant statistical test.
On the other hand, dialysis duration, the cause of renal failure and
presence or absence of comorbidities had not affect the total score of QOL in
our patients with non-significant statistical tests.
Regarding general fatigue, in our study the mean score was 63.09. The
gender was the only factor affecting the general fatigue scores which contribute
the mean score for males was 75.9 and for females was 62.66 which is
statistically significant and the other factors are not statistically significant.
As regard About My Kidney Disease, in our study the mean score was
53.85. The gender and age were the factors affecting this domain scores which
represent the mean score for males was 62.35 and for females was 45.8 with
significant statistical test. For age, the subgroup 5- <8 years had better QOL than
others as the mean score was 85 with significant statistical test.
In our study the mean score for treatment problems was 61.42. The age
was the only factor affecting this scale scores as the subgroup 8- <13 years had
better QOL than others with the mean score was 76.56 with significant statistical
test.