Open Access Study protocol

Health and wealth in children and adolescents with chronic kidney disease (K-CAD study)

Germaine Wong123*, Meredith Medway1, Madeleine Didsbury1, Allison Tong2, Robin Turner4, Fiona Mackie5, Steven McTaggart6, Amanda Walker7, Sarah White8, Kirsten Howard2, Siah Kim1 and Jonathan C Craig2

Author Affiliations

1 Centre for Kidney Research, Kids Research Institute, The Children’s Hospital at Westmead, Sydney, Australia

2 Sydney School of Public Health, The University of Sydney, Sydney, Australia

3 Centre for Transplant and Renal Research, Westmead Hospital, Sydney, Australia

4 Department of Biostatistics, University of New South Wales, Sydney, Australia

5 Department of Renal Medicine, Sydney Children’s Hospital at Randwick, Sydney, Australia

6 Department of Renal Medicine, The Royal Children’s Hospital, Brisbane, Australia

7 Department of Renal Medicine, The Royal Children’s Hospital, Melbourne, Australia

8 Sydney Medical School, The University of Sydney, Sydney, Australia

For all author emails, please log on.

BMC Public Health 2014, 14:307  doi:10.1186/1471-2458-14-307

Published: 4 April 2014



The impact of reduced kidney function in children is substantial. End-stage kidney disease (ESKD), the most severe form of chronic kidney disease (CKD), is a devastating illness associated with substantially increased mortality, impaired growth and psychosocial maladjustment in children. Understanding how to address the complex causes of mortality and morbidity in children with CKD requires explicit information about the risk factors that lead to adverse outcomes. In addition to biological influences, the socioeconomic circumstances of caregivers may play a significant role in the health and well-being of children with CKD.


A prospective cohort study (n = 380 children and n = 380 caregivers) will be conducted to determine the prevalence of economic hardship among caregivers of children with CKD. All participants will be followed biennially over a period of 5 years to determine the association between the changing socioeconomic status of the caregivers and the health and overall well-being of school-aged children with CKD. Face to face, semi-structured interviews with the caregivers (n = 45) will also be conducted to understand their perspectives on the economic, financial and psychosocial impact of CKD and how this affects the health outcomes of their child with CKD. The primary outcomes of the study are the effects of the socioeconomic status of the caregivers and self-reported health status of the children. Secondary outcomes included the prevalence of economic hardship and the distribution of wealth among the caregivers of children with CKD.


Findings from this study presents not only a snapshot of the current economic and social situation of the caregivers of children and adolescents with CKD but will also provide definitive evidence of determining whether a link between socioeconomic status of caregivers and outcomes of children with CKD exists.

Socioeconomic status; Chronic kidney disease; Quality of life; Mortality; Cohort studies; Qualitative