LAUSR

Background Children with mild to moderate chronic kidney disease (CKD) are at increased risk for deficits in neurocognition. Less is known about how CKD affects emotional-behavioral functioning in this population. Methods Parent ratings of emotional-behavioral functioning at baseline and over time were examined for 845 children with mild to moderate CKD using the Behavior Assessment System for Children, Second Edition Parent Rating Scales (BASC-2 PRS). Associations with demographic and disease-related predictors were also examined. Results Children with mild to moderate CKD had parent-reported emotional-behavioral functioning largely within normal limits, at baseline and over time. The proportion with T -scores at least 1 SD above the mean was 24% for Internalizing Problems and 28% for Attention Problems. A greater proportion of participants scored lower than expected (worse) on scales measuring adaptive skills (25%). Persistent hypertension predicted attention problems ( β  = 1.59, 95% CI = 0.24 to 2.94, p  < 0.02) and suggested worse behavioral symptoms ( β  = 1.36, 95% CI = − 0.01 to 2.73, p  = 0.05). Participants with proteinuria at baseline, but not at follow-up, had fewer attention problems than participants whose proteinuria had not resolved ( β  = − 3.48, CI = − 6.79 to − 0.17, p  < 0.04). Glomerular diagnosis was related to fewer ( β  = − 2.68, 95% CI = − 4.93 to − 0.42, p  < 0.02) internalizing problems. Conclusions Although children with CKD generally have average emotional-behavioral parent ratings, a notable percentage of the population may be at risk for problems with attention and adaptive behavior. Providers working with this population should facilitate psychosocial referrals when indicated.