357 Health-related quality of life in children with nephrotic syndrome: a preliminary report

Abstract

<h3>Background</h3> Nephrotic Syndrome (NS) is the commonest chronic glomerular disease of childhood. A majority (70–80%) have relapsing disease persisting throughout childhood. Any chronic childhood disease causes psychosocial impact and behavioural difficulties that have implications for the mental health, social and personality development of the child. <h3>Objectives</h3> To assess the quality of life (QOL) in children with NS compared to a matched healthy control group. <h3>Methods</h3> A case-control study was conducted in the nephrology clinic, Lady Ridgeway Hospital for Children, Colombo to assess the quality of life (QOL) in children with NS compared to a matched healthy control group. A self-administered multi-dimensional questionnaire of Paediatric Quality of Life Inventory 4 (PedsQL^TM) was used to collect data. The tool evaluates the QOL in four domains: physical, emotional, social and school functioning, with higher PedsQL scores indicating a better QOL. Descriptive and analytical statistics were performed to compare scores. Possible predictors of poor outcome among the cases were assessed by both univariate and multivariate analysis. <h3>Results</h3> A total of 51 cases and 23 controls aged 5–18 (9.96±3.41) year and 6–13 (9.2±2.34) years, respectively, were included in the analysis. The mean PedsQL 4.0 Generic Core Scale score was found to be lower in cases compared to healthy controls. (78.94 vs 88.8) but there was no significant difference (p=0.176). There was a significantly lower score in the physical domain (79.65 vs 93.97, p = 0.02, p&lt;0.05). However, emotional (77.65 vs 83.82), social (82.20 vs 89.00) and school (68.43 vs 86.11) functioning were not significantly different between cases and controls (p &gt; 0.05). Children with hypertension had significantly lower mean PedsQL score compared to children without hypertension (71.6 vs 82.14, p = 0.04, p&lt;0.05). There were significantly lower scores in physical (65.14 vs 85.93, p=0.01, p&lt;0.05) and social (77.19 vs 84.56, p = 0.04, p&lt;0.05) domains. <h3>Conclusions</h3> The mean PedsQL scores in all domains were lower in children with nephrotic syndrome with a significant difference in the physical domain. Hypertension was an independent risk factor associated with lower quality of life.