الفهرس 
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Abstract
Chronic kidney disease (CKD) is a gradual decline in kidney function that occurs over a prolonged period of time, typically lasting months or even years. The manifestations of deteriorating renal function are not specific.
Children diagnosed with chronic kidney disease (CKD) frequently undergo various bodily changes resulting from the disease itself and the immunosuppressive treatment employed to manage it. CKD-associated growth retardation, as well as the presence of implanted devices for feeding or dialysis access, significantly impact the physical, emotional, and sexual development of these children. These physiological side effects set individuals apart from their peers and have a negative impact on their self-confidence.
The survival rates for children with CKD have been enhanced due to advancements in medical care, such as improvements in dialysis and transplantation.The extended duration of survival enhances the likelihood of psychiatric illness emergence in these children. The prevalence and presentation of psychiatric disorders in children with CKD exhibit significant variation across different studies. CKD poses a persistent hindrance to a child’s regular physical, emotional, and social activities. Additionally, CKD imposes a financial burden on the patient’s family, which negatively impacts their own daily necessities.
The objective of this study was to evaluate the presence of psychological disorders in children suffering from chronic kidney disease.
This study is a cross-sectional hospital-based conducted at Minia University Hospital of Pediatrics.
This study comprised a cohort of 200 pediatric patients, ranging in age from 6 to 18 years, who were diagnosed with chronic kidney disease. These patients were selected from those who sought medical care at the outpatient nephrology clinic, dialysis unit, and pediatric nephrology department between February and July 2023.Written consent was acquired from the parents of every patient.
Studied children were classified into two groups:
group I: included 100 patients suffering from CKD on regular dialysis, 3 sessions per week (Their age range was from 6:18).
group II: included 100 patients suffering from CKD not on regular dialysis. (Their age range was 6:18).
The Child Behavior Checklist (CBCL) is a parental questionnaire used to identify emotional and behavioral issues in children and adolescents.The CBCL is a component of the Achenbach System of Empirically Based Assessment (ASEBA). Specifically, the CBCL/6-18 is designed for children between the ages of 6 and 18. The assessment has 113 questions, which are evaluated using a three-point scale (0=not present, 1=occurs occasionally, 2=occurs frequently). The item responses are limited to the previous six-month period.
The CBCL/6-18 consists of eight subscales:
The time used to administer the questionnaire and explain its contents to the parent was around 40 minutes. The questionnaire assessed many issues including depression, somatic disorders, social problems, thought problems, attention problems, anxiety, delinquent behavior, withdrawal, and aggressive behavior.
Greater issues are indicated by higher scores. The interpretation of scores for each symptom, internalizing and externalizing problem scales, and the total score can be categorized as normal, borderline, or clinical behavior. Any score below the 93rd percentile is considered within the normal range, scores between the 93rd and 97th percentiles are considered borderline clinical, and any score beyond the 97th percentile is considered inside the clinical range.
Our findings indicate a greater prevalence of total internalization and externalization behavioral abnormalities in children with chronic kidney disease (CKD) who undergo regular dialysis compared to CKD children who do not undergo regular dialysis.
Typical instances of physical health hazards include stunted growth, reliance on the dialysis machine both physically and mentally, limitations on fluid intake and certain dietary factors, reduced time spent in school due to extended absences, delayed progression from childhood to adulthood, and difficulty forming close relationships with peers.
Children undergoing dialysis must adhere to frequent food alterations throughout their treatment for their condition and its therapeutic interventions. Simultaneously, the growth and maturation of dialysis patients are at their most active stages, greatly influenced by dietary habits and food selections during childhood and adolescence.Furthermore, prevalent instances of psychological health dangers encompass emotional and behavioral disorders. Constant contemplations revolve on the belief in the futility of life, enduring ceaseless agony, the absence of a lasting remedy, the difficulties of leading a conventional existence, and the absence of hopeful prospects for a more favorable future.It is essential to provide consistent and thorough therapy for children undergoing dialysis in order to maximize their psychosocial well-being to a level close to normal. The dialysis nurse, in their capacity as a primary caregiver, plays a crucial role in conducting continuous evaluations, identifying certain issues, assisting with the medical treatment, delivering well-informed and compassionate care to emotionally support the families of patients, and aiding them in addressing feelings of guilt or blame towards their siblings.