Changes in Self-Care, Treatment Adherence, and Renal Function in Children with Cystic Fibrosis

Document Type : original article

Authors

1 Assistant Professor of Pediatric Nephrology, Department of Pediatrics, School of Medicine, Bouali Hospital, Ardabil University of Medical Sciences, Ardabil, Iran.

2 Assistant Professor of Pediatrics Gastroenterology, Department of Pediatrics, School of Medicine, Bouali Hospital, Ardabil University of Medical Sciences, Ardabil, Iran.

3 Department of Pediatrics, School of Medicine, Bouali Hospital, Ardabil University of Medical Sciences, Ardabil, Iran.

4 Assistant Professor of Pediatric Pulmonology, Department of Pediatrics, School of Medicine, Bouali Hospital, Ardabil University of Medical Sciences, Ardabil, Iran.

5 Professor of Health Education and Promotion, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran.

10.22038/jpp.2025.92029.5606

Abstract

Background: Cystic fibrosis (CF) is a chronic and progressive disease that requires continuous care and management. Self-care and treatment adherence play crucial roles in the effective management of these patients, particularly in children.  The present study aimed to assess the status of self-care, treatment adherence, and renal function indicators in children with CF, as well as to analyze their changes over a six-month period.
Methods: In this longitudinal study, 30 children with CF were evaluated on an outpatient basis at two time points: baseline and six months later. Data on nutritional self-care and treatment adherence were collected using validated questionnaires. Laboratory indicators including serum creatinine, blood urea nitrogen (BUN), estimated glomerular filtration rate (eGFR), blood glucose, and urinary protein-to-creatinine ratio were measured. Parametric statistical tests and linear mixed-effects regression models were applied for data analysis.
Results: The mean age was 10 years, with a mean body mass index of 15.5 kg/m², and the majority were male. The mean self-care score significantly declined over the six-month period (p = 0.024), while treatment adherence showed no significant change (p = 0.787). Serum creatinine (p = 0.019) and blood glucose (p = 0.009) levels increased significantly, whereas eGFR decreased (p = 0.003). Time was the only variable that had a significant effect on eGFR and creatinine (p < 0.05); self-care and treatment adherence scores had no significant impact. A significant negative correlation was observed between self-care and the urinary protein-to-creatinine ratio (r = -0.508, p < 0.01).
Conclusion: The observed decline in self-care and renal function among children with CF over time highlights the need for structured, multidimensional, and long-term interventions aimed at improving self-care and treatment adherence. Regular monitoring of renal function is also recommended for these patients.

Keywords

References

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Journal of Pediatric Perspectives
Volume 13, Issue 12
December 2025
Pages 19809-19818

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