Abstract
BackgroundThere is no information about HRQoL, depression and associated factors in adult with nephrotic syndrome-associated glomerulopathy.Methodology/Principal FindingsPatients with primary glomerulopathy where compared with age and sex-matched hemodialysis patients and healthy subjects. Laboratory data, medical history, comorbid conditions were collected to evaluate factors associated with HRQoL (SF-36) and Depression (Hamilton Depression Rating Scale - HAMD). Glomerulopathy patients had low HRQoL in all eight SF-36 domains and two composite scores (physical and mental) in comparison with healthy subjects. HAMD score also was elevated and there was high depression prevalence. Overall, these data were comparable between glomerulopathy and hemodialysis patients. Using multiple regression analysis, factors associated with low HRQoL physical composite score were: last 24 h-urine protein excretion (−0.183, 95%CI −0.223 to −0.710 for each gram of proteinuria, p = 0.01) and cyclosporine use (−15.315, 95%CI −25.913 to −2.717, p = 0.03). Low HRQoL mental composite score was associated with last 24 h-urine protein excretion (−0.157, 95%CI −0.278 to −0.310 for each gram of proteinuria, p = 0.03) and HMAD score was independently associated with age (0.155, 95%CI 0.318 to 0.988 for each year, p = 0.04), female sex (4.788, 95%CI 1.005 to 8.620, 0 = 0.03), disease duration (0.074, 95%CI 0.021 to 0.128 for each month, p = 0.01) and last 24 h-urine protein excretion (0.050, 95%CI 0.018 to 0.085 for each gram of proteinuria, p = 0.02).Conclusions/SignificanceNephrotic-syndrome associated glomerulopathy patients have low HRQoL and high prevalence of depression symptoms, comparable with those of hemodialysis patients. Last 24 h-protein excretion rate is independently associated with physical and mental HRQoL domains in addition to depression.
Highlights
Glomerulopathy is a group of diseases that affect mainly young adults between 20–40 years old [1]
Many nephrotic syndrome features are related to a worse health-related quality of life (HRQoL): protein-nutrition alteration [2], lipid metabolism alteration [3] and reduced glomerular filtration rate (GRF) [4]
Depression is thought to be associated with worse general health status [6] and is associated with several chronic diseases [7,8], including chronic Kidney disease (CKD) [9]
Summary
Glomerulopathy is a group of diseases that affect mainly young adults between 20–40 years old [1]. Patients with nephrotic syndrome generally present with important edema, lipid alterations, hypoalbuminemia, and possible loss of renal function. Treatment involves dietary restrictions and immunosuppression therapy with their adverse effects. All these factors can potentially affect health-related quality of life (HRQoL). Many nephrotic syndrome features are related to a worse HRQoL: protein-nutrition alteration [2], lipid metabolism alteration [3] and reduced glomerular filtration rate (GRF) [4]. Depression is common in general medical patients, with female prevalence of 5 to 9% and 2 to 3% in men [5]. There is no information about HRQoL, depression and associated factors in adult with nephrotic syndromeassociated glomerulopathy
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