Health-related quality of life in pediatric patients with stage 5 chronic kidney disease receiving kidney replacement therapy in Honduras: a descriptive cross-sectional study from a national referral center

Purpose: This study aimed to characterize health-related quality of life (HRQoL) in children with stage 5 chronic kidney disease receiving dialysis (CKD G5D) in Honduras and describe their unmet needs.Methods: Cross-sectional study of 35 patients with CKD G5D on kidney replacement therapy (KRT) hemodialysis (n=19) or peritoneal dialysis (n=16) at one of the two main national referral units providing chronic pediatric KRT (July 2023–November 2024). Data came from records and interviews. HRQoL was assessed with the TECAVNER questionnaire (57 items, 14 domains, maximum score 5,700), categorized as poor, moderate, or good. Sociodemographic/clinical variables were described by modality. TECAVNER domains were described for the total cohort; modality comparisons (Mann-Whitney U test with Holm-Bonferroni correction) were exploratory given limited power.Results: Median age was 14 years (interquartile range, 11–16 years); 65.7% were from rural areas, and 97.1% had an unsatisfied basic household need. Short stature occurred in 54.3% and thinness/severe thinness in 40.0%. HRQoL was predominantly good (68.6% highest category; none poor). Domain scores were heterogeneous: pain, general health perception, symptoms, and time devoted to medical care approached maximum scores, while school attendance had a median of 0/100 in both groups, alongside low scores in physical activity, fatigue-energy, social relations, and emotional effect. The study lacked power to detect between- modality differences (minimum detectable area under the curve 0.78 uncorrected, 0.87 corrected).Conclusions: Honduran pediatric KRT patients reported predominantly good overall HRQoL but with consistent deficits; near-universal school absenteeism is the most clinically relevant unmet need, supporting integration of educational support and a national longitudinal registry.