Assessment of Stress Levels in Parents of Children With and Without Chronic Kidney Disease Psychological Impacts on Caregivers in Pediatric Nephrology
Journal of Pediatric Nephrology,
Vol. 13 No. 1 (2025),
12 Ordibehesht 2026
https://doi.org/10.22037/jpn.v13i1.49694
Abstract
Background and Aim: Chronic kidney disease (CKD) in children poses significant
psychological challenges for parents, potentially leading to elevated levels of stress, anxiety,
and depression. This study aimed to compare levels of stress, anxiety, health anxiety, and
depression between parents of children diagnosed with CKD and parents of healthy children.
Methods: This cross-sectional comparative study included 70 parents (35 parents of
children with chronic kidney disease and 35 parents of healthy children) recruited from Amir
Kabir Children’s Hospital in Arak, Iran. Psychological outcomes, including stress, anxiety,
depression, and health anxiety were assessed using the depression, anxiety, and stress scale
(DASS-21) and the 18-item health anxiety inventory (HAI-18). Statistical analyses was
performed using SPSS software, version 26.
Results: Parents of children with CKD reported significantly higher levels of anxiety
(P=0.044) and stress (P=0.047) compared to the control group. However, there were no
statistically significant differences in depression levels (P=0.117) or health anxiety (P=0.840).
Demographic variables showed no significant correlation with psychological outcomes.
Conclusion: Parents of children with CKD experience elevated levels of stress and anxiety,
underscoring the need for targeted psychological interventions to support their mental health.
- Chronic Kidney Disease
- Anxiety
- Stress
- Depression
- Health anxiety
How to Cite
References
[1] Aier A, Pais P, Raman V. Psychological aspects in children
and parents of children with chronic kidney disease and
their families. Clin Experiment Pediatr. 2022; 65(5):222-9.
[DOI:10.3345/cep.2021.01004] [PMID]
[2] Moreira JM, Bouissou Morais Soares CM, Teixeira AL,
Simões e Silva AC, Kummer AM. Anxiety, depression, resilience
and quality of life in children and adolescents with
pre-dialysis chronic kidney disease. Pediatr Nephrol. 2015;
30(12):2153-62. [DOI:10.1007/s00467-015-3159-6] [PMID]
[3] Kidney Disease: Improving Global Outcomes (KDIGO)
CKD-MBD Update Work Group. KDIGO 2017 clinical practice
guideline update for the diagnosis, evaluation, prevention,
and treatment of chronic kidney disease-mineral and
bone disorder (CKD-MBD). Kidney Int Suppl. 2017; 7(1):1-59.
[DOI:10.1016/j.kisu.2017.10.001] [PMID]
[4] Jha V, Garcia-Garcia G, Iseki K, Li Z, Naicker S, Plattner B,
et al. Chronic kidney disease: Global dimension and perspectives.
Lancet. 2013; 382(9888):260-72. [DOI:10.1016/S0140-
6736(13)60687-X] [PMID]
[5] Harambat J, van Stralen KJ, Kim JJ, Tizard EJ. Epidemiology
of chronic kidney disease in children. Pediatr Nephrol. 2012;
27(3):363-73. [DOI:10.1007/s00467-011-1939-1] [PMID]
[6] Becherucci F, Roperto RM, Materassi M, Romagnani P.
Chronic kidney disease in children. Clin Kidney J. 2016;
9(4):583-91. [DOI:10.1093/ckj/sfw047] [PMID]
[7] Tsai TC, Liu SI, Tsai JD, Chou LH. Psychosocial effects on
caregivers for children on chronic peritoneal dialysis. Kidney
Int. 2006; 70(11):1983-7. [DOI:10.1038/sj.ki.5001811] [PMID]
[8] Copelovitch L, Warady BA, Furth SL. Insights from the Chronic
Kidney Disease in Children (CKiD) study. Clin J Am Soc Nephrol.
2011; 6(8):2047-53. [DOI:10.2215/CJN.10751210] [PMID]
[9] Adejumo OA, Iyawe IO, Akinbodewa AA, Abolarin OS, Alli
EO. Burden, psychological well-being and quality of life of
caregivers of end stage renal disease patients. Ghana Med J.
2019; 53(3):190-6. [DOI:10.4314/gmj.v53i3.2] [PMID]
[10] Mahmoud DAM, Saad A, Abdelhamid YH, El Hawary Y.
Depression and psychosocial burden among caregivers of
children with chronic kidney disease. Middle East Curr Psychiatr.
2021; 28(1):12. [DOI:10.1186/s43045-021-00092-x]
[11] Asghari A, Saed F, Dibajnia P. Psychometric properties of
the depression anxiety stress scales-21 (DASS-21) in a nonclinical
Iranian sample. Int J psychol. 2008; 2(2):82-102. [Link]
[12] Salkovskis PM, Rimes KA, Warwick HM, Clark DM.
The Health anxiety inventory: Development and validation
of scales for the measurement of health anxiety and hypochondriasis.
Psychol Med. 2002; 32(5):843-53. [DOI:10.1017/
S0033291702005822] [PMID]
[13] Nargesi F, Izadi F, Kariminejad K, Rezaii Sharif A. [The
investigation of the reliability and validity of Persian version
of Health anxiety questionnaire in students of Lorestan
University of Medical Sciences (Peraian)]. Educ Meas. 2017;
8(27):147-60. [DOI:10.22054/jem.2017.19621.1495]
[14] De Bruyne E, Eloot S, Willem L, Van Hoeck K, Walle JV,
Raes A, et al. Mental health and professional outcomes in parents
of children with chronic kidney disease. Pediatr Nephrol.
2024; 39(9):2741-52. [DOI:10.1007/s00467-024-06372-y]
[PMID]
[15] Elorza CLC, Santos Junior AD, Celeri E. Quality of life, depression
and anxiety in children and adolescents with CKD
and their primary caregivers. J Bras Nefrol. 2023; 45(3):335-43.
[DOI:10.1590/2175-8239-jbn-2022-0036pt] [PMID]
[16] Al Maqbali A, Al Omari O, Abu Sharour L, Al-Naamani Z,
Al Khatri M, Sanad HM, et al. The perceived levels of stress,
anxiety and depression among family caregivers of patients
undergoing haemodialysis and their association with quality
of life. BJPsych Open. 2025; 11(3):e100. [DOI:10.1192/
bjo.2025.44] [PMID]
[17] Lima AGT, Sales CCDS, Serafim WFL. Burden, depression
and anxiety in primary caregivers of children and adolescents
in renal replacement therapy. J Bras Nefrol. 2019; 41(3):356-63.
[DOI:10.1590/2175-8239-jbn-2018-0039] [PMID]
[18] Ford EC, Sohansoha GK, Patel NA, Billany RE, Wilkinson
TJ, Lightfoot CJ, et al. The association of micro and macro worries
with psychological distress in people living with chronic
kidney disease during the COVID-19 pandemic. Plos One.
2024; 19(10):e0309519. [DOI:10.1371/journal.pone.0309519]
[PMID]
[19] Xiong HY, Zhang G, Wang L, Li Z, Shen Q, Li Y, et al.
Psychological research of the children with chronic kidney
disease and their guardians during the COVID-19 pandemic.
Front Public Health. 2022; 10:922678. [DOI:10.3389/
fpubh.2022.922678] [PMID]
- Abstract Viewed: 41 times
- pdf Downloaded: 7 times