How to help your child cope with kidney disease

Kidney disease and its treatment, including renal replacement or dialysis, can have an impact on children's overall mental health and wellbeing. Kids who are diagnosed with kidney disease, like our patient Izayah, deal with disruption to their daily lives, school schedules and social life because of their treatment. In addition, some patients, especially teens, must manage a restrictive diet which can be challenging and feel limiting.

"While there has been great improvement in the management and care of pediatric chronic kidney disease, this disease requires daily management, which can be compounded with psychosocial stressors," says Adrienne Anderson, Ph.D., Pediatric Psychologist in the Nephrology Department at Children's Health℠. "It is important to understand the influences of psychosocial factors, including impacts on the patient and family's quality of life."

Chronic kidney disease and its impact on mental health

Children and teens with chronic kidney disease are at risk of experiencing other concerns associated with their condition, which can lead to nonadherence to treatment plans and, as a result, poorer outcomes. These challenges include:

• Developmental delays

• Dietary restrictions

• Family stressors

• Financial stressors

• Physical impacts

• Psychological impacts

Psychological and physical impacts from kidney disease often influence one another. The disease often reminds children that they are different from their peers, which can lead to feelings of alienation and distress. "Children with chronic kidney disease often deal with body image concerns because of delayed growth, scars from catheter or fistula placement, frequent needle sticks and side effects of their medication," says Dr. Anderson. "Some patients with chronic kidney disease may be smaller in stature and appear younger than their counterparts. Others may be embarrassed or hesitant to show their scarring, so they're not asked questions by their peers."

Children and teens with chronic kidney disease also have to deal with dialysis treatments several days a week, if not daily. These disruptions can impact their education, social life and emotional development. Many children feel socially isolated from missing school or other activities.

Common mental health issues associated with kidney disease

Children and teens with chronic kidney disease may be at higher risk for mental health and behavioral issues. Approximately 30% of children and adolescents with this condition also display symptoms of depression. Additionally, research shows a higher level of behavioral disorders for children with chronic kidney disease, including attention concerns and disruptive behavior disorders.

"Research has shown that patients with chronic kidney disease reported higher levels of stress and worry related to their own health, their burden on their families, and perceived and real limitations," says Dr. Anderson.

Fortunately, according to Dr. Anderson, many treatments that address mood, anxiety, and behavioral concerns can be used to support children and teens with kidney disease. "Pediatric psychologists adapt traditional approaches to meet the unique needs of patients with chronic health conditions," she says. "These strategies include developing coping behaviors during hospitalizations, targeting unhelpful thoughts about their health and providing families with strategies to help manage behavior concerns."

Cognitive-behavioral therapy, which focuses on challenging negative thinking and promoting healthier behaviors, is a gold-standard treatment for treating anxiety and mood symptoms. Other treatments include behavior therapy and acceptance and commitment therapy.

Helping children with kidney disease cope

At home, parents can also help their children manage their mental health. Some of these support strategies include:

• Engaging in play or activities that your child enjoys

• Finding support from your child's school, including 504 and Individual Education Plan accommodations

• Maintaining routines and age-appropriate activities as much as medically able

• Seeking out activities to bolster peer interaction

• Sourcing mental health resources when necessary

• Talking with your child's health care team

Children and teens can also take ownership of their own mental health. Some ways to get involved include:

• Confiding in a trusted adult when feeling down

• Engaging in fun activities

• Finding peer support groups

• Sharing feelings with the health care team

• Utilizing coping skills and creative outlets, like journaling, listening to music or drawing

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The Pediatric Nephrology division at Children's Health has a dedicated psychologist as part of their multidisciplinary team to help patients navigate their treatment plans. Learn more about Pediatric Nephrology at Children's Health.