Date of Award

8-2019

Document Type

Dissertation

Degree Name

Doctor of Psychology (PsyD)

Department

Psychology

First Advisor

William Meil

Second Advisor

David LaPorte

Third Advisor

Stephanie Davis

Abstract

Pediatric chronic kidney disease (CKD) is associated with several comorbidities, including hypertension, anemia, and growth hormone deficiency. Thus, treatment of CKD requires a complex medical regimen to manage the disease process, even within the mild to moderate stages. Previous research has focused its efforts on examining children with CKD who have progressed to end stage renal disease (ESRD), and less research has been conducted within the mild to moderate CKD pediatric population. As such, the Chronic Kidney Disease in Children (CKiD) study was developed to examine physical, neurocognitive, and psychosocial functioning in children and adolescents with mild to moderate CKD. Previous research has shown that proper management of CKD and its comorbidities can improve neurocognitive and psychosocial functioning within this population. The aim of the present study was to better understand the effects of medication burden (number of unique medications prescribed) and medication adherence on executive (EF) and psychosocial functioning in adolescents with CKD. Adolescent participants from the CKiD cohort prescribed any medication, antihypertensives, and erythropoiesis-stimulating agents (ESAs) were used within the analyses. Results suggested that higher medication burden is predictive of poorer psychosocial functioning. However, this result is likely not clinically significant as medication burden explained only 3% of the change in psychosocial functioning. Medication burden was not predictive of EF, which is likely due to parent-reported EF falling within age-appropriate ranges and low medication burden within this population. Similarly, there was a lack of effect between adherence to antihypertensives and ESAs and EF and psychosocial functioning. Participants within the present study reported high adherence and there was little variability among reported adherence. Additionally, parent-reported EF fell generally within age-appropriate ranges. Together, this likely explained the lack of effect between medication adherence and EF and psychosocial functioning. It is also possible there was too little variability in adherence to truly examine the impact of medication adherence on EF and psychosocial functioning within the present study.

Share

COinS