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Naim FS, Bakhiet YM, Mohmmedahmed MA, Yousef BA. Health-Related Quality of Life in Sudanese Children with Nephrotic Syndrome: A Comparative Cross-Sectional Study. Pediatric Health Med Ther 2024; 15:133-144. [PMID: 38563042 PMCID: PMC10984192 DOI: 10.2147/phmt.s437364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 03/22/2024] [Indexed: 04/04/2024] Open
Abstract
Background Nephrotic syndrome (NS) is an essential chronic disease in children that has a major impact on a child's health-related quality of life (HRQoL). This study aimed to evaluate the HRQoL of Sudanese children with NS and clinical parameters that can influence their HRQoL. Methods This study was a descriptive cross-sectional of children with NS conducted in Khartoum state hospitals. A standardized PedsQLTM 4.0 Scale Score evaluated the HRQoL of the participants. Patients' socio-demographics, clinical data, and disease complications were collected using a data collection sheet. This study assessed the HRQoL of children with NS and compared it with apparent age and sex-matched to three groups (healthy children, children with chronic diseases, and kidney-transplanted children). Results 80 children with NS were recruited from April to August 2021. Children over eight years old represented (63.8%) of the study subjects. The total mean HRQoL scores of nephrotic children were significantly lower than those of healthy children (78.46 ± 24.01) (p = 0.001) and those with other chronic diseases (78.45 ± 24.01) (p= 0.006); however, it was not significantly different from those with kidney transplantation. Socio-demographics did not significantly affect the total mean HRQoL scores of children with NS. Clinical parameters such as the duration of illness, "less than one year" (p= 0.006), and the minimum change nephropathy histopathology (p= 0.035) significantly lowered the total mean HRQoL scores of NS children. Regression analysis further confirmed that edema, proteinuria, and hospital admission had a high impact on the total mean HRQoL. Conclusion The total mean HRQoL scores of children with NS were low and significantly lower than healthy children. Parameters such as the patient's socio-demographics and phenotype of NS had no significant effect on the total mean HRQoL scores of children with NS. However, other clinical parameters significantly lowered their total mean HRQoL scores.
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Affiliation(s)
- Fatima S Naim
- Department of Clinical Pharmacy, Faculty of Pharmacy, University of Khartoum, Khartoum, Sudan
| | - Yassir M Bakhiet
- Department of Pediatric Nephrology, Soba University Hospital, Khartoum, Sudan
| | | | - Bashir A Yousef
- Department of Pharmacology, Faculty of Pharmacy, University of Khartoum, Khartoum, Sudan
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Veltkamp F, Teela L, Luijten MAJ, van Oers HA, Mak-Nienhuis EM, Haverman L, Bouts AHM. Health-related quality of life of children with first onset steroid-sensitive nephrotic syndrome. Eur J Pediatr 2023; 182:4605-4614. [PMID: 37548700 PMCID: PMC10587200 DOI: 10.1007/s00431-023-05135-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 07/20/2023] [Accepted: 07/24/2023] [Indexed: 08/08/2023]
Abstract
This study assessed HRQoL and emotional and behavioral difficulties (EBD) and associated variables in children with first onset SSNS. While relapsing steroid-sensitive nephrotic syndrome (SSNS) in children is associated with lower health-related quality of life (HRQoL), little is known about first onset. Four weeks after onset, children (2-16 years) and/or their parents who participated in a randomized placebo-controlled trial, completed the Pediatric Quality of Life Inventory 4.0 (PedsQL) and Strengths and Difficulties Questionnaire (SDQ) to measure HRQoL and EBD, respectively. Total and subscale scores and the proportion of children with impaired HRQoL (> 1 SD below the mean of the reference group) or SDQ clinical scores (< 10th and > 90th percentile) were compared to the Dutch general population (reference group). Regression analyses were used to identify associated variables. Compared to the reference group, children 8-18 years reported significantly lower total HRQoL, and physical and emotional functioning. A large proportion (> 45%) of these children had impaired HRQoL. There were no differences in HRQoL between children 2-7 years and the reference group, except for higher scores on social functioning (5-7 years). Similar proportions of SSNS and reference children scored within the clinical range of SDQ subscales. Age, sex, and steroid side-effects were negatively associated with HRQol and/or EBD. Conclusion: This study showed that HRQoL and EBD are affected in children of different ages with first onset SSNS. This calls for more awareness from healthcare providers and routinely monitoring of HRQoL and EBD in daily clinical care to prevent worsening of symptoms. Clinical trial registry: Netherlands Trial Register ( https://trialsearch.who.int/ ; NTR7013), date of registration: 02 June 2018. What is Known: • Health-related quality of life (HRQoL) is lower and emotional and behavioral difficulties (EBD) is more affected in children with frequently-relapsing and steroid-dependent nephrotic syndrome. What is New: • HRQoL and EBD are affected in children with first onset steroid-sensitive nephrotic syndrome compared to a reference group of the Dutch general population. • To what extent HRQoL and EBD are affected depends on the age of the patient.
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Affiliation(s)
- Floor Veltkamp
- Amsterdam University Medical Centers location University of Amsterdam, Emma Children's Hospital, Department of Pediatric Nephrology, Meibergdreef 9, Post box 22660, 1100 DD, Amsterdam, the Netherlands
- Amsterdam Reproduction and Development, Child Development, Amsterdam, The Netherlands
| | - Lorynn Teela
- Amsterdam Reproduction and Development, Child Development, Amsterdam, The Netherlands
- Amsterdam University Medical Centers, location University of Amsterdam, Emma Children's Hospital, Child and Adolescent Psychiatry & Psychosocial Care, Meibergdreef 9, Amsterdam, The Netherlands
| | - Michiel A J Luijten
- Amsterdam Reproduction and Development, Child Development, Amsterdam, The Netherlands
- Amsterdam University Medical Centers, location University of Amsterdam, Emma Children's Hospital, Child and Adolescent Psychiatry & Psychosocial Care, Meibergdreef 9, Amsterdam, The Netherlands
| | - Hedy A van Oers
- Amsterdam Reproduction and Development, Child Development, Amsterdam, The Netherlands
- Amsterdam University Medical Centers, location University of Amsterdam, Emma Children's Hospital, Child and Adolescent Psychiatry & Psychosocial Care, Meibergdreef 9, Amsterdam, The Netherlands
- Amsterdam Public Health, Mental Health, Amsterdam, the Netherlands
| | - Elske M Mak-Nienhuis
- Amsterdam University Medical Centers location University of Amsterdam, Emma Children's Hospital, Department of Pediatric Nephrology, Meibergdreef 9, Post box 22660, 1100 DD, Amsterdam, the Netherlands
| | - Lotte Haverman
- Amsterdam Reproduction and Development, Child Development, Amsterdam, The Netherlands
- Amsterdam University Medical Centers, location University of Amsterdam, Emma Children's Hospital, Child and Adolescent Psychiatry & Psychosocial Care, Meibergdreef 9, Amsterdam, The Netherlands
- Amsterdam Public Health, Mental Health, Amsterdam, the Netherlands
| | - Antonia H M Bouts
- Amsterdam University Medical Centers location University of Amsterdam, Emma Children's Hospital, Department of Pediatric Nephrology, Meibergdreef 9, Post box 22660, 1100 DD, Amsterdam, the Netherlands.
- Amsterdam Reproduction and Development, Child Development, Amsterdam, The Netherlands.
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Takahashi T, Okamoto T, Yokota I, Sato Y, Hayashi A, Ueda Y, Aoyagi H, Ueno M, Kobayashi N, Uetake K, Nakanishi M, Ariga T. The effect of rituximab on the quality of life of children with refractory nephrotic syndrome. Pediatr Int 2022; 64:e14725. [PMID: 33826766 DOI: 10.1111/ped.14725] [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: 12/20/2020] [Revised: 03/23/2021] [Accepted: 04/02/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Rituximab (RTX) is an effective treatment for maintaining remission in patients with nephrotic syndrome (NS), but there are few reports on the effect of RTX treatment on quality of life (QOL). The purpose of this study was to examine the effect of periodically repeated RTX treatment from the perspective of QOL. METHODS We systematically assessed the QOL of pediatric patients with refractory NS and parents' perceptions of their children's QOL through a 2 year RTX treatment protocol. Pediatric patients from Hokkaido University Hospital with refractory NS who met our specific criteria were enrolled between January 2015 and December 2015. The RTX infusion was performed 4 times at 6-month intervals, followed by mizoribine administration with early discontinuation of calcineurin inhibitors. Quality of life scores were measured by the Pediatric Quality of Life Inventory version 4.0 (PedsQL) at each RTX administration and evaluated 2 years later. RESULTS Twenty-two patients were analyzed. The patients' QOL and their parents' perceptions of their QOL improved over our 2 year treatment protocol. Nevertheless, the parents' scores were lower than the patients' scores on all scales, with slower improvement. CONCLUSIONS Our treatment protocol showed a significant improvement of QOL in patients with refractory NS. Although the risk of the RTX treatment should be considered, the treatment is useful for patients with refractory NS.
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Affiliation(s)
- Toshiyuki Takahashi
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Takayuki Okamoto
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Isao Yokota
- Department of Biostatistics, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Yasuyuki Sato
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Asako Hayashi
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Yasuhiro Ueda
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Hayato Aoyagi
- Department of Pediatrics, Obihiro Kyokai Hospital, Obihiro, Japan
| | - Michihiko Ueno
- Department of Pediatrics, Nikko Memorial Hospital, Muroran, Japan
| | - Norio Kobayashi
- Department of Pediatrics, Oji General Hospital, Tomakomai, Japan
| | - Kimiaki Uetake
- Department of Pediatrics, Obihiro Kosei Hospital, Obihiro, Japan
| | | | - Tadashi Ariga
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Japan
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Ruslie RH, Darmadi D, Pakpahan C. Health-Related Quality of Life Difference between Early Diagnosed and Finished Therapy of Nephrotic Syndrome in Children. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.6601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Nephrotic syndrome is the most common glomerular disease in children with high economic burden. The management of nephrotic syndrome at present is not only focusing in outcomes of disease but also the burden related to health-related quality of life (HRQOL). HRQOL of children with nephrotic syndrome is influenced by steroid dependence, steroid resistance, cytotoxic therapy, frequency of relapse, disease severity, socioeconomic status, and duration of illness.
AIM: The objective of the study is to determine the difference of HRQOL in children between early diagnosed nephrotic syndrome and finished therapy of nephrotic syndrome.
METHODS: A cross-sectional study was conducted between January and December 2018. Subjects were children aged 1–18 years with nephrotic syndrome and then divided into 2 groups based on either in the 1st week of full dose corticosteroid treatment or in the 1st week after finishing therapy equally. Demographical data, nutritional status, and laboratory results were obtained. HRQOL was measured using PedsQL 4.0 questionnaire in the Indonesian language. The difference of HRQOL was analyzed using independent T-test.
RESULTS: A total of 100 subjects enrolled in this study and divided into two groups. Male-to-female ratio was 4:1 in early diagnosed group and 7.3:1 in finished therapy group. Mean age of subjects for the early diagnosed group was 4.6 years and finished therapy group was 5.3 years. Total HRQOL was improved after treatment administration in children with nephrotic syndrome (p < 0.001). The improvement was most significant in physical domain (p = 0.002).
CONCLUSION: HRQOL in children with early diagnosed nephrotic syndrome was lower compared to children with finished therapy of nephrotic syndrome.
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Aronu AE, Uwaezuoke SN, Muoneke UV. Reliability of generic quality-of-life instruments in assessing health-related quality of life among children and adolescents with idiopathic nephrotic syndrome: a systematic review. Health Qual Life Outcomes 2021; 19:144. [PMID: 33980318 PMCID: PMC8209644 DOI: 10.1186/s12955-021-01786-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 05/04/2021] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Most of the studies reporting the negative impact of idiopathic nephrotic syndrome on health-related quality of life in children and adolescents were conducted with generic quality-of-life instruments rather than disease-specific instruments. The consistency of these studies' findings using these generic instruments is not well established. AIM This systematic review aims to determine the reliability of current generic quality-of-life instruments in assessing health-related quality of life among children and adolescents with idiopathic nephrotic syndrome. METHODS We searched the PubMed, MEDLINE, EMBASE, and Google Scholar databases for articles published between 2000 and 2020, using appropriate descriptors. We included primary studies that met the eligibility criteria, independently screened their titles and abstracts, and removed all duplicates during the study-selection process. We resolved disagreements until a consensus was reached on study selection. We independently retrieved relevant data, including the generic quality-of-life instruments and the subjects' and controls' aggregate health-related quality of life scores, using a preconceived data-extraction form. RESULTS Ten original articles were selected for qualitative and quantitative analyses. Some of the studies reported the following significant findings. The mean health-related quality of life scores for children with prevalent and incident nephrotic syndrome were 68.6 (range, 52.6-84.6) and 73.7 (range, 55.9-91.5), respectively. Children with idiopathic nephrotic syndrome and their controls with other chronic diseases had median scores of 65 (interquartile range, 59-68.75) and 62.2 (interquartile range, 58.05-65.78). Patients on oral immunosuppressive drug and intravenous rituximab reportedly had median scores of 76.2 and 72.6 and mean scores of 71.4 (range, 55.4-87.4) and 61.6 (range, 42.1-81.1) respectively for quality-of-life assessment on the 'school functioning domain.' CONCLUSIONS The health-related quality of life scores in patients with idiopathic nephrotic syndrome are consistently low. Lower scores occur in prolonged disease duration and severe clinical phenotypes, whereas the scores are higher than the scores obtained in other chronic diseases. These consistent findings underscore the reliability of the current generic instruments in assessing health-related quality of life in patients with idiopathic nephrotic syndrome.
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Affiliation(s)
- Ann E Aronu
- Department of Pediatrics, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, 400001, Nigeria.,College of Medicine, The University of Nigeria, Ituku-Ozalla Enugu campus, Nigeria
| | - Samuel N Uwaezuoke
- Department of Pediatrics, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, 400001, Nigeria. .,College of Medicine, The University of Nigeria, Ituku-Ozalla Enugu campus, Nigeria.
| | - Uzoamaka V Muoneke
- Department of Pediatrics, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, 400001, Nigeria.,College of Medicine, The University of Nigeria, Ituku-Ozalla Enugu campus, Nigeria
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Mizerska-Wasiak M, Adamczuk D, Cichoń-Kawa K, Miklaszewska M, Szymanik-Grzelak H, Pietrzyk JA, Pukajło-Marczyk A, Zwolińska D, Rybi-Szumińska A, Wasilewska A, Bieniaś B, Sikora P, Firszt-Adamczyk A, Stankiewicz R, Szczepańska M, Pańczyk-Tomaszewska M. Health-related quality of life in children with immunoglobulin A nephropathy - results of a multicentre national study. Arch Med Sci 2021; 17:84-91. [PMID: 33488859 PMCID: PMC7811315 DOI: 10.5114/aoms.2020.100367] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 06/07/2018] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION Immunoglobulin A nephropathy (IgAN) may lead to end stage renal disease and severely affect patient functioning and wellbeing. The aim of the study was to evaluate health-related quality of life (HRQoL) in children and adolescents with IgAN, and compare HRQoL in relation to the disease course, social status and psychological factors, such as expressing anger and perceived personal competence. MATERIAL AND METHODS The multicentre cross-sectional study included 51 patients ≥ 8 years from 7 paediatric nephrology centres in Poland. Psychometric analysis was performed using the Kidscreen-52 questionnaire to evaluate HRQoL, the Anger Expression Scale to evaluate the severity of anger and the Personal Competence Scale to measure general perception of personal competence. RESULTS Mean age of patients was 14.54 ±3.69 years; duration since the diagnosis of IgAN was 4.98 ±3.9 years. Patients with IgAN rated their psychological wellbeing as significantly worse compared to healthy peers (p < 0.05). The presence of proteinuria was associated with significantly worse physical wellbeing (58.72 ±18.45 vs. 74.44 ±22.97; p < 0.05). Current therapy (steroids/immunosuppressive drugs) had no effect on HRQoL in the study group. Perceived personal competence was rated high by 49% of children in the study group. Children with IgAN were characterized by lower intensity of expressed anger (p < 0.001) and significantly higher intensity of suppressed anger (p < 0.01) compared to reference ranges. Severity of expressed anger correlated positively with the parent relations and school environment dimensions of HRQoL. CONCLUSIONS We found lower HRQoL in regard to physical and psychological wellbeing in a group of Polish children with IgAN compared to healthy peers. HRQoL should be monitored in this patient group.
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Affiliation(s)
| | - Dominika Adamczuk
- Department of Pediatrics and Nephrology, Medical University of Warsaw, Warsaw, Poland
| | - Karolina Cichoń-Kawa
- Department of Pediatrics and Nephrology, Medical University of Warsaw, Warsaw, Poland
| | - Monika Miklaszewska
- Department of Paediatric Nephrology, Jagiellonian University Medical College, Krakow, Poland
| | | | - Jacek A. Pietrzyk
- Department of Paediatric Nephrology, Jagiellonian University Medical College, Krakow, Poland
| | | | - Danuta Zwolińska
- Department and Clinic of Paediatric Nephrology, Wroclaw Medical University, Wroclaw, Poland
| | | | - Anna Wasilewska
- Department of Pediatrics and Nephrology, Medical University of Bialystok, Bialystok, Poland
| | - Beata Bieniaś
- Department of Paediatric Nephrology, Medical University of Lublin, Lublin, Poland
| | - Przemysław Sikora
- Department of Paediatric Nephrology, Medical University of Lublin, Lublin, Poland
| | | | - Roman Stankiewicz
- Department of Paediatric Nephrology, Provincial Polyclinical Hospital, Torun, Poland
| | - Maria Szczepańska
- Department of Paediatric Nephrology, Medical University of Silesia, Katowice, Poland
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Time to Relapse and Its Predictors among Children with Nephrotic Syndrome in Comprehensive Specialized Hospitals, Tigray, Ethiopia, 2019. Int J Pediatr 2020; 2020:8818953. [PMID: 33299427 PMCID: PMC7704192 DOI: 10.1155/2020/8818953] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 09/16/2020] [Accepted: 10/29/2020] [Indexed: 01/19/2023] Open
Abstract
Background Relapse in children with nephrotic syndrome leads to a variety of complications due to prolonged treatment and potential dependency on steroids. However, there is no study conducted to determine the incidence and predictive factors of relapse for nephrotic syndrome in Ethiopia, especially in children. Thus, this study aimed to assess the incidence of relapse and its predictors among children with nephrotic syndrome in Ethiopia. Methods A retrospective study was conducted by reviewing all charts of children with an initial diagnosis of the nephrotic syndrome in tertiary hospitals from 2011 to 2018. Charts of children with a diagnosis of steroid-resistant cases were excluded. The extraction tool was used for data collection, Epi-data manager V-4.4.2 for data entry, and Stata V-14 for cleaning and analysis. Kaplan-Meier curve, log-rank test, life table, and crude hazard ratios were used to describe the data and adjusted hazard ratios with 95% CI and P value for analysis. Median relapse time, incidence rate of relapse, and cumulative relapse probabilities at a certain time interval were computed. Bivariable and multivariate analyses were performed using the Cox proportional hazard regression to identify the factors associated with relapse. Any variable at P < 0.25 in the bivariable analysis was transferred to multivariate analysis. Then, the adjusted hazard ratio with 95% CI and P ≤ 0.05 was used to report the association and to test the statistical significance, respectively. Finally, texts, tables, and graphs were used to present the results. Results and Conclusion. Majority, 64.5% (40/66), of relapses were recorded in the first 12 months of follow-up. The incidence rate of relapse was 42.6 per 1000 child-month-observations with an overall 1454 child-month-observations and the median relapse time of 16 months. Having undernutrition [AHR = 3.44; 95% CI 1.78-6.65], elevated triglyceride [AHR = 3.37; 95% CI 1.04-10.90], decreased serum albumin level [AHR = 3.51; 95% CI 1.81-6.80], and rural residence [AHR = 4.00; 95% CI 1.49-10.76] increased the hazard of relapse. Conclusion and Recommendation. Relapse was higher in the first year of the follow-up period. Undernutrition, hypoalbuminemia, hypertriglyceridemia, and being from rural areas were independent predictors of relapse. A focused evaluation of those predictors during the initial diagnosis of the disease is compulsory.
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Lee JM, Kronbichler A, Shin JI, Oh J. Review on long-term non-renal complications of childhood nephrotic syndrome. Acta Paediatr 2020; 109:460-470. [PMID: 31561270 DOI: 10.1111/apa.15035] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 08/15/2019] [Accepted: 09/25/2019] [Indexed: 12/23/2022]
Abstract
BACKGROUND Nephrotic syndrome (NS) is the most common glomerular childhood disease. A body of literature has described the long-term renal prognosis of childhood-onset idiopathic NS. However, the nonrenal outcomes have not been studied as much. AIM We aimed to discuss the long-term non-renal outcomes of childhood NS, highlighting studies with a follow-up period of more than 10 years. RESULTS We reviewed the literature and found that a number of immunosuppressive agents have stopped inflammation, stabilised the podocyte cytoskeleton and reduce proteinuria. However, prolonged treatment has frequently been associated with a high risk of renal and non-renal complications in patients with a complicated disease course, defined as frequent relapses or steroid dependency. Non-renal complications may include impaired longitudinal growth and pubertal development, undesirable fertility outcomes, ocular complications, bone mineral diseases and potential malignancies. CONCLUSION This review discusses and summarises the non-renal outcomes of idiopathic childhood NS.
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Affiliation(s)
- Jiwon M. Lee
- Department of Pediatrics Chungnam National University Hospital and College of Medicine Daejeon Korea
| | - Andreas Kronbichler
- Department of Internal Medicine IV (Nephrology and Hypertension) Medical University Innsbruck Innsbruck Austria
| | - Jae Il Shin
- Department of Pediatrics Yonsei University College of Medicine Seoul Korea
- Division of Pediatric Nephrology Severance Children's Hospital Seoul Korea
- Institute of Kidney Disease Research Yonsei University College of Medicine Seoul Korea
| | - Jun Oh
- Department of Pediatrics University Hamburg‐Eppendorf Hamburg Germany
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Roussel A, Delbet J, Micheland L, Deschênes G, Decramer S, Ulinski T. Quality of life in children with severe forms of idiopathic nephrotic syndrome in stable remission-A cross-sectional study. Acta Paediatr 2019; 108:2267-2273. [PMID: 31240744 DOI: 10.1111/apa.14912] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 06/19/2019] [Accepted: 06/24/2019] [Indexed: 11/27/2022]
Abstract
AIM Severe forms of idiopathic nephrotic syndrome (INS) require immunosuppressive therapy: oral treatment or intravenous therapy (rituximab, RTX). The main objective was to describe quality of life (QOL) in these specific patients. METHODS Cross-sectional, multicentre, observational study analysed QOL using a standardised questionnaire in children from 7 to 17 years, with a steroid-dependent or steroid-resistant INS in stable remission. The questionnaire consisted of 30 questions concerning physical and emotional well-being, self-esteem, family, friends, school and disease resulting in a global score of 0-100. RESULTS A total of 110 patients with a mean age of 11.6 years from three French paediatric nephrology centres were included. A total of 71 patients had oral immunosuppressive treatment, 27 had RTX, and 12 had both. 13.6% of patients had a steroid-resistant INS. The mean number of relapses was 5.8. Seventy-eight patients answered the questionnaire. The global score in the whole study population was 74.7; 72.6 in the RTX group, 76.2 in the oral drugs group, (P = 0.49). The results of sub-dimension 'school' were statistically lower in RTX group (61.6 ± 19.5) compared with oral drugs group (71.4 ± 16; P = 0.02). CONCLUSION Global QOL score was high in 'difficult-to-treat' patients with INS in stable remission on oral immunosuppressive or RTX treatment.
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Affiliation(s)
- Aphaia Roussel
- Service de Néphrologie et Dialyse Pédiatrique Hôpital Trousseau, APHP.6, and DHU i2b Paris France
| | - Jean‐Daniel Delbet
- Service de Néphrologie et Dialyse Pédiatrique Hôpital Trousseau, APHP.6, and DHU i2b Paris France
| | | | - Georges Deschênes
- Service de Néphrologie Pédiatrique Hôpital Robert Debré, AP‐HP Paris France
| | | | - Tim Ulinski
- Service de Néphrologie et Dialyse Pédiatrique Hôpital Trousseau, APHP.6, and DHU i2b Paris France
- Sorbonne Université Paris France
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