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Klein M, Obermaier M, Mutze H, Wilden SM, Rehberg M, Schlingmann KP, Schmidt D, Metzing O, Hübner A, Richter-Unruh A, Kemper MJ, Weitz M, Wühl E, Jorch N, Patzer L, Freiberg C, Heger S, Ziviknjak M, Schnabel D, Haffner D. Health-related quality of life of children with X-linked hypophosphatemia in Germany. Pediatr Nephrol 2024:10.1007/s00467-024-06427-0. [PMID: 38914781 DOI: 10.1007/s00467-024-06427-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 05/02/2024] [Accepted: 05/28/2024] [Indexed: 06/26/2024]
Abstract
BACKGROUND X-linked hypophosphatemia (XLH) is a rare inherited phosphate-wasting disorder associated with bone and dental complications. Health-related quality of life (HRQoL) is reduced in XLH patients on conventional treatment with phosphate supplements and active vitamin D, while information on patients treated with burosumab is rare. METHODS HRQoL was assessed in 63 pediatric XLH patients participating in a prospective, observational study and patient registry in Germany using the KIDSCREEN-52 survey instrument and standardized qualitative interviews. RESULTS The median age of the XLH patients was 13.2 years (interquartile range 10.6 - 14.6). At the time of the survey, 55 (87%) patients received burosumab and 8 (13%) conventional treatment. Forty-six patients (84%) currently being treated with burosumab previously received conventional treatment. Overall, HRQoL was average compared to German reference values (mean ± SD: self-report, 53.36 ± 6.47; caregivers' proxy, 51.33 ± 7.15) and even slightly above average in some dimensions, including physical, mental, and social well-being. In general, XLH patients rated their own HRQoL higher than their caregivers. In qualitative interviews, patients and caregivers reported that, compared with conventional therapy, treatment with burosumab reduced stress, bone pain, and fatigue, improved physical health, and increased social acceptance by peers and the school environment. CONCLUSIONS In this real-world study in pediatric XLH patients, HRQoL was average or even slightly above that of the general population, likely due to the fact that the vast majority of patients had their treatment modality switched from conventional treatment to burosumab resulting in improved physical health and well-being.
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Affiliation(s)
- Martin Klein
- Department of Social Sciences, Catholic University of Applied Sciences North Rhine, Westphalia, Cologne, Germany
| | - Michael Obermaier
- Department of Social Sciences, Catholic University of Applied Sciences North Rhine, Westphalia, Cologne, Germany
| | - Helena Mutze
- Department of Social Sciences, Catholic University of Applied Sciences North Rhine, Westphalia, Cologne, Germany
| | - Sophia Maria Wilden
- Department of Social Sciences, Catholic University of Applied Sciences North Rhine, Westphalia, Cologne, Germany
| | - Mirko Rehberg
- Department of Pediatrics, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Cologne, Germany
| | - Karl Peter Schlingmann
- Department of General Pediatrics, Pediatric Nephrology, University Children's Hospital, Münster, Germany
| | - Dorothee Schmidt
- Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics and Adolescent Medicine, University of Lübeck, Lübeck, Germany
| | | | - Angela Hübner
- Division of Pediatric Endocrinology, Department of Pediatrics, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | | | - Markus J Kemper
- Asklepios Children's Hospital Hamburg-Heidberg, Hamburg, Germany
| | - Marcus Weitz
- Department of Pediatrics I, University Children's Hospital Heidelberg, Heidelberg, Germany
| | - Elke Wühl
- Division of Pediatric Nephrology, Center for Pediatrics and Adolescent Medicine, Heidelberg University, Heidelberg, Germany
| | - Norbert Jorch
- University Children's Hospital, Evangelisches Klinikum Bethel, Bielefeld, Germany
| | - Ludwig Patzer
- St. Elisabeth and St. Barbara Children's Hospital, Halle/Saale, Germany
| | - Clemens Freiberg
- Department of Pediatrics and Adolescent Medicine, University Medical Center Göttingen, Göttingen, Germany
| | - Sabine Heger
- Kinderkrankenhaus auf der Bult, Hannover, Germany
| | - Miroslav Ziviknjak
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Carl-Neuberg-Str. 1, D-30625, Hannover, Germany
| | - Dirk Schnabel
- Center for Chronically Sick Children, Pediatric Endocrinology, University Medicine, Charitè, Berlin, Germany
| | - Dieter Haffner
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Carl-Neuberg-Str. 1, D-30625, Hannover, Germany.
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Hillert S, Naab S, Hillert A. [Loneliness in Adolescents Against the Background of the COVID-19 Pandemic: A Risk Factor]. ZEITSCHRIFT FUR KINDER- UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2023; 51:139-151. [PMID: 35904434 DOI: 10.1024/1422-4917/a000889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Loneliness in Adolescents Against the Background of the COVID-19 Pandemic: A Risk Factor Abstract. On the one hand, loneliness is the subjective experience of inadequate social integration and support. It is a normal phenomenon that can be dealt with in an emotional and action-oriented way within the framework of individual development. On the other hand, chronic loneliness goes hand in hand with considerable suffering, reduced quality of life, and an increased risk of psychological and somatic diseases. In the context of current social developments associated with the fragmentation of social networks and programmatic individualism, we discuss an increase in the problem of loneliness, especially among young people. Interventions to reduce the experience of loneliness are effective if, in addition to making social offers, they focus on the dynamics common in chronic loneliness (low self-esteem, evaluation of neutral communication as devaluing, etc.). There is no evidence that the use of virtual social networks persistently reduces feelings of loneliness in young people. In addition, the question arises on what basis of shared values and goals social integration of young people who experience loneliness will be possible in the future. According to the results of the first systematic surveys on the psychosocial consequences of the COVID-19 pandemic, we must assume that the loneliness problem of young people will continue to gain relevance because of the associated massive restrictions on real social life.
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Affiliation(s)
- Sophia Hillert
- Schön Klinik Roseneck, Prien am Chiemsee, Deutschland.,PFH Göttingen, Deutschland.,Tiroler Landeskonservatorium, Innsbruck, Österreich
| | - Silke Naab
- Schön Klinik Roseneck, Prien am Chiemsee, Deutschland
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