The Clinical Parameters Affecting the Health-Related Quality of Life of Children with Nephrotic Syndrome

Introduction: Nephrotic syndrome is a common chronic kidney disease of childhood whose characteristics can significantly affect the health-related quality of life (HRQoL) of affected individuals. It is the most common renal disorder requiring admission and accounts for about 40% of all renal disorders in our setting. The aim of this study is to assess the quality of life of children with nephrotic syndrome and to determine those factors that adversely affect it.

Methods: It was a descriptive cross sectional study of only children with nephrotic syndrome. The health-related quality of life of eligible children was assessed with PedsQLTM 4.0 Scale Score. Data obtained for physical, emotional, social and school domains were analyzed using the Statistical Package for Social Sciences (SPSS) version 19.0.

Results: Fifty children aged 5-18 years, 33 (66%) males and 17 (34%) females with nephrotic syndrome were recruited over a period of about one year. The mean + SD for total scale of subjects without oedema, negative proteinuria, steroid sensitive and Minimal Change Nephrotic Syndrome histopathology (MCNS) are 81.26 + 13.17, 84.78+ 10.17, 80.98+ 13.36 and 87.19 + 6.72 respectively. While that of subjects with oedema, highest degree of proteinuria, steroid resistance and cytotoxic therapy and non-MCNS are 69.48 + 11.21(t = 2.87, p = 0.0006), 65.58 + 11.63(t = 7.76, p =0.001), 73.64 + 12.17(t = 1.89, p = 0.066), and 74.82 + 12.82(t= 2.70, p = 0.012). Subjects with duration of illness < a year have means + SD total scale score of 74.01 + 13.39 and that of subjects with illness duration > one year is 79.38 + 13.62(t = 1.16, p = 0.25).

Conclusion: The HRQoL of children with nephrotic syndrome is worse with presence of oedema, disease severity (massive proteinuria, steroid resistance, non-MCNS histology type, cytotoxic therapy).

Keywords: Nephrotic syndrome, Quality of Life, Health- related Quality of Life, Children.