Pub Date : 2025-01-01Epub Date: 2025-05-23DOI: 10.52768/annpediatr/1152
Joann Carlson, Erin M Jones, Sharon Manne, Matthew B Matheson, Lyndsay A Harshman, Bradley A Warady, Susan Furth, Stephen R Hooper, Rebecca J Johnson
Objective: The COVID-19 (C19) pandemic impacted youth mental/behavioral health with a 25% increase in prevalence of anxiety and depression worldwide. Little is known about the emotional impact of C19 for children with Chronic Kidney Disease (CKD). The purpose of the current study is to describe C19-related distress and worry among youth with CKD.
Methods: C19 questionnaire adapted from the SARS-CoV-19 worry scale was completed for participants. Covariate data were collected at or prior to C19 questionnaire administration.Analyses examined rates of C19 emotional distress and worry and included logistic regression to identify associations with socioeconomic and disease-related covariates.
Results: The sample included 320 participants from the Chronic Kidney Disease in Children Study: 63% male, 18% African American, 10% Hispanic, median age 16 years, median estimated GFR 52 ml/min/1.73m2 among pre-End Stage Kidney Disease (ESKD) participants and median urine P:C 0.27. 27% were post-kidney replacement, 29% had household income <$36,000 and 29% had maternal education of high school or less. 19% and 17% endorsed C19-related emotional distress and worry, respectively. Having eGFR <30 pre-ESKD was associated with endorsement of emotional distress (OR 3.34; p=0.046). Low household income was associated with endorsement of C19-related worry (OR 5.43; p=0.01).
Conclusion: 15-19% of youth and young adults with CKD endorsed elevated rates of C19-associated emotional distress and worry. Findings suggest that children with poorer kidney function and lower income were more likely to endorse distress and worry related to C19.
{"title":"COVID-19 Associated Worry and Emotional Distress in Youth and Young Adults with Chronic Kidney Disease.","authors":"Joann Carlson, Erin M Jones, Sharon Manne, Matthew B Matheson, Lyndsay A Harshman, Bradley A Warady, Susan Furth, Stephen R Hooper, Rebecca J Johnson","doi":"10.52768/annpediatr/1152","DOIUrl":"10.52768/annpediatr/1152","url":null,"abstract":"<p><strong>Objective: </strong>The COVID-19 (C19) pandemic impacted youth mental/behavioral health with a 25% increase in prevalence of anxiety and depression worldwide. Little is known about the emotional impact of C19 for children with Chronic Kidney Disease (CKD). The purpose of the current study is to describe C19-related distress and worry among youth with CKD.</p><p><strong>Methods: </strong>C19 questionnaire adapted from the SARS-CoV-19 worry scale was completed for participants. Covariate data were collected at or prior to C19 questionnaire administration.Analyses examined rates of C19 emotional distress and worry and included logistic regression to identify associations with socioeconomic and disease-related covariates.</p><p><strong>Results: </strong>The sample included 320 participants from the Chronic Kidney Disease in Children Study: 63% male, 18% African American, 10% Hispanic, median age 16 years, median estimated GFR 52 ml/min/1.73m<sup>2</sup> among pre-End Stage Kidney Disease (ESKD) participants and median urine P:C 0.27. 27% were post-kidney replacement, 29% had household income <$36,000 and 29% had maternal education of high school or less. 19% and 17% endorsed C19-related emotional distress and worry, respectively. Having eGFR <30 pre-ESKD was associated with endorsement of emotional distress (OR 3.34; p=0.046). Low household income was associated with endorsement of C19-related worry (OR 5.43; p=0.01).</p><p><strong>Conclusion: </strong>15-19% of youth and young adults with CKD endorsed elevated rates of C19-associated emotional distress and worry. Findings suggest that children with poorer kidney function and lower income were more likely to endorse distress and worry related to C19.</p>","PeriodicalId":520084,"journal":{"name":"Annals of pediatrics","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12525824/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145310533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mensur Zvekic, Maddie Herbert, Alba Morales, Samir Softic
Metabolic Dysfunction Associated Steatotic Liver disease is the most common cause of chronic hepatitis in children and adults. The patients with MASLD have low thyroid hormone activity in the liver. Recent evidence suggests that patients with MASLD may also have haptic growth hormone deficiency. Here, we present a case of a 13-year-old adolescent with obesity and short stature whose liver enzymes normalized with growth hormone therapy. The patient initially presented to the primary care physician's office, revealing a BMI in the 93rd percentile and elevated liver enzymes (ALT = 170 U/L, AST = 94 U/L). Subsequent visits showed a BMI in the 96th percentile, with further elevation in liver enzymes (ALT = 179 U/L, AST = 101 U/L). Following six months of lifestyle intervention, BMI decreased to the 91st percentile, and liver enzymes improved (ALT = 72 U/L, AST = 56 U/L), but did not normalize. Other causes of chronic hepatitis were excluded. Concurrently, screening for short stature revealed delayed bone age, although insulin-like growth factor 1 (IGF1) and insulin-like growth factor-binding protein 3 (IGFB3) levels were normal. Moreover, the patient failed a growth hormone (GH) stimulation test, revealing GH deficiency, corroborated by MRI findings of pituitary hypoplasia. GH therapy was initiated at pubertal doses. Nine months of GH therapy entirely normalized liver enzymes (ALT = 18, AST = 23), and BMI was reduced to the 75th percentile. GH therapy should be further investigated in adolescents with short stature and MASLD.
{"title":"Growth Hormone Treatment Normalized Liver Enzymes in an Adolescent with Obesity and Short Statute.","authors":"Mensur Zvekic, Maddie Herbert, Alba Morales, Samir Softic","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Metabolic Dysfunction Associated Steatotic Liver disease is the most common cause of chronic hepatitis in children and adults. The patients with MASLD have low thyroid hormone activity in the liver. Recent evidence suggests that patients with MASLD may also have haptic growth hormone deficiency. Here, we present a case of a 13-year-old adolescent with obesity and short stature whose liver enzymes normalized with growth hormone therapy. The patient initially presented to the primary care physician's office, revealing a BMI in the 93rd percentile and elevated liver enzymes (ALT = 170 U/L, AST = 94 U/L). Subsequent visits showed a BMI in the 96th percentile, with further elevation in liver enzymes (ALT = 179 U/L, AST = 101 U/L). Following six months of lifestyle intervention, BMI decreased to the 91st percentile, and liver enzymes improved (ALT = 72 U/L, AST = 56 U/L), but did not normalize. Other causes of chronic hepatitis were excluded. Concurrently, screening for short stature revealed delayed bone age, although insulin-like growth factor 1 (IGF1) and insulin-like growth factor-binding protein 3 (IGFB3) levels were normal. Moreover, the patient failed a growth hormone (GH) stimulation test, revealing GH deficiency, corroborated by MRI findings of pituitary hypoplasia. GH therapy was initiated at pubertal doses. Nine months of GH therapy entirely normalized liver enzymes (ALT = 18, AST = 23), and BMI was reduced to the 75th percentile. GH therapy should be further investigated in adolescents with short stature and MASLD.</p>","PeriodicalId":520084,"journal":{"name":"Annals of pediatrics","volume":"7 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11373495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142135018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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