Health-Related Quality of Life in Sudanese Children with Nephrotic Syndrome: A Comparative Cross-Sectional Study

Figures & data

Table 1 Distribution of Socio-Demographic Characteristics and Disease State Among the Children Patients with Nephrotic Syndrome (n=80)

Demographic and Clinical Data	Number (Frequency %)
Gender
Males	54 (67.5)
Females	26 (32.5)
Age group
Toddler (2–4 years)	11 (13.8)
Young Children (5–7 years)	18 (22.5)
Children (8–12 years)	26 (32.5)
Teens (13–18 years)	25 (31.3)
Age mean years (Mean± SD)	9.73 ± 4.39
Origin
Center	32 (40)
North	11 (13)
East	8 (10)
West	9 (11.3)
South	20 (25)
Phenotype of NS
SSNS	27 (33.8)
SRNS	31 (38.8)
SDNS / FRNS	22 (27.5)
Type of NS According to the histopathology
MCNS	12 (15)
Non-MCNS (MN)	5 (6.3)
Non-MCNS (FSGS)	15 (18.7)
Not performed biopsy	48 (60)
Duration of illness
≤ One year	36 (45)
> One year	44 (55)
Degree of proteinuria
Nil	27 (33.8)
+ 1	12 (15)
+ 2	23 (28.7)
+ 3	18 (22.5)
Edema	38 (47.5)
Disease-related complications
Persistence hypertension	49 (61.2)
Infection	24 (30)
Thromboembolism	6 (7.5)
Acute kidney injury	3 (3.8)
Admission to hospital
Inpatient	13 (16.3)
Outpatient	67 (83.7)
Treatment
Prednisolone	43 (53.8)
Cyclosporine	4 (5)
Combination	23 (28.7)
No treatment	10 (12.5)

Abbreviations: SD, Standard deviation; SSNS, Steroid-sensitive nephrotic syndrome; SRNS, Steroid-resistant nephrotic syndrome; SDNS, Steroid-dependent nephrotic syndrome; FRNS, Frequent resistant nephrotic syndrome; MCNS, minimal-change nephropathy syndrome; MN, Membranous nephropathy; FSGS, Focal segmental glomerulosclerosis.

Table 2 Distribution of Health-Related Quality of Life (HRQoL) According to Various Socio-Demographic Characteristics of Children with Nephrotic Syndrome (N= 80)

Socio-Demographic	HRQoL Domain (Mean± SD)
	Physical	Emotional	Social	School	Total score
Gender
Males (N= 54)	81.25 ± 26.40	84.44 ± 27.31	83.24 ± 28.16	74.59 ± 25.33	80.88 ± 23.15
Female (N= 26)	71.39 ± 33.37	73.46 ± 31.36	84.03 ± 27.85	64.67 ± 31.78	73.42 ± 25.43
P value	0.126	0.094	0.99	0.32	0.39
Age group
Toddler (2–4 years) (N= 11)	96.3±6.7	86±25.6	94.5±12.9	81.8±34.5	89.63±15.44
Young children (5–7 years) (N=18)	82.6±31.8	90.5±23	89.4±25.3	85.3±18.2	86.9±21.33
Children (8–12 years) (N= 26)	73.6 ± 30.8	76.2 ± 32	77 ± 34.7	66.3 ± 27	72.5 ± 28.57
Teens (13–18 years) (N= 25)	71.3 ± 28.4	76.6 ± 30.2	81.2 ± 25.5	62 ± 27.2	72.78 ± 21.31
P value	0.077	0.315	0.247	0.018*	0.059
Origin
Center (N= 32)	80.2±26.2	79±30.8	84±29	78.4±26.3	80±24.6
North (N= 11)	80.1±27.2	81.4±27.6	83.6±32	77±22.4	80.5±24.8
South (N= 20)	75.1±31.5	76.3±31	79.3±30.4	65.5±27.8	74.08±25.3
East (N= 8)	77.7±25.5	95.6±8.2	88.7±15.5	56.3±27.2	79.5±15.5
West (N= 9)	74.6±41.5	83.8±32	86.7±25.4	64.8±34.4	77.5±28.6
P value	0.97	0.6	0.93	0.16	0.92

Notes: Data presented as the mean ± standard deviation (SD), For all relevant tables, the * P value is significant (<0.05).

Abbreviations: HRQoL, Health-related quality of life; SD, Standard deviation.

Table 3 Distribution of Health-Related Quality of Life (HRQoL) According to Various Clinical Data of Children with Nephrotic Syndrome (N= 80)

Clinical variable	HRQoL Domain (Mean± SD)
	Physical	Emotional	Social	School	Total score
Phenotype of NS
SSNS (N= 27)	77.43 ± 33.9	77.22 ± 30.92	81.8 ± 31.47	78.14 ± 27.39	78.6 ± 26.26
SRNS (N= 31)	75.5 ± 26.9	84.6 ± 29	84.83 ±27.6	63.2 ± 28.3	77 ± 23.9
SDNS / FRNS (N= 22)	82.3 ± 25.8	80 ± 26.9	83.6 ± 24.5	74.5 ± 25.76	80.1 ± 22.08
P value	0.69	0.617	0.92	0.102	0.89
Histopathology
MCNS (N= 12)	64± 28	70.8± 37.46	71± 39.3	65±30	67.84± 30.6
Non-MCNS (N= 20)	80± 25	90.23± 21	88.3±22.4	66±23.8	81.3± 19.58
P value	0.543	0.003*	0.006*	0.398	0.035*
Duration of illness
≤ One year (N= 36)	69.28±34.5	74.8±30.3	77.1±31.3	71±31.2	73.09±27.22
> One year (N= 44)	84.8±21.9	85.5±27.2	88.4±24.6	71.6±25.1	82.6±20.5
P value	0.001*	0.08	0.014*	0.174	0.006*
Degree of proteinuria
Nil	88.9 ± 16	87.4 ± 23.3	91.7 ±19	79.4 ± 23	86.8 ±14.64
+ 1 (N= 12)	88 ± 17.8	87 ± 23.8	90.4 ± 15.7	73.8 ± 20.7	84.8 ±16.2
+ 2 (N= 23)	73.2 ± 33	78.2 ± 29	83 ± 29.1	72.6 ± 27.8	76.8 ± 27.05
+ 3 (N= 18)	61.3 ± 36.3	70.3 ± 37.2	67.2 ± 37.2	56 ± 33.8	63.69 ± 29.3
P value	0.006*	0.211	0.024*	0.044*	0.009*
Hospital admission
Inpatient (N= 13)	45.19 ± 37.75	47.69 ± 34.79	55 ± 38.24	42.56 ± 28.95	47.6 ± 25.69
Outpatient (N= 67)	84.90 ± 22.2	87.3 ± 22.9	89.02 ± 21.7	76.9 ± 24	84.44 ± 18.61
P value	0.003*	0.013*	0.001*	0.488	0.009*
Edema
Yes (N= 38)	66.6 ± 34.49	72.1±34.04	74.8± 32.2	62.7± 28.37	69.07± 27.5
No (N= 42)	88.3±17.8	88.8 ± 20.8	91.3 ± 20.69	79.2 ± 25.08	86.95 ± 16.5
P value	0.001*	0.009*	0.008*	0.437	0.001*
Treatment
Yes (N= 70)	76.5± 30	78.8± 30	81.8± 29.4	69.8± 28.5	76.58± 24.8
No (N= 10)	90.9 ± 16.8	98.3±5	95±10.8	82±17.5	91.6± 10.98
P value	0.021*	0.001*	0.005*	0.079	0.008*

Abbreviations: HRQoL, Health-related quality of life; SD, Standard deviation, SSNS, Steroid-sensitive nephrotic syndrome; SRNS, Steroid-resistant nephrotic syndrome; SDNS, Steroid-dependent nephrotic syndrome; FRNS, Frequent resistant nephrotic syndrome; MCNS, Minimal-change nephropathy syndrome.

Table 4 Distribution of Health-Related Quality of Life (HRQoL) According to Various Disease Complications and Treatment Approaches for Children with Nephrotic Syndrome (N= 80)

Variable	HRQoL Domain (Mean± SD)
	Physical	Emotional	Social	School	Total Score
Hypertension
Yes (N= 49)	74.79 ± 30.35	73.06 ± 32.80	81.45 ± 32.63	63.27 ± 29.37	73.14 ± 27.33
No (N=31)	80.10 ± 28.25	85.81 ± 25.35	84.79 ± 24.70	76.49 ± 25.73	81.81 ± 21.26
P value	0.468	0.017*	0.170	0.756	0.056
Infection
Yes (N= 24)	58±34.7	64±35.6	67.2±34	63±31.8	85.4±16.88
No (N=56)	87.1±20.6	88.5±21.7	90.9±20.9	75.2±25.1	63.04 ±29.94
P value	0.001*	0.001*	0.001*	0.129	0.001*

Abbreviations: HRQoL, Health-related quality of life; SD, Standard deviation.

Table 5 Linear Regression Analysis for the Predictors of the Total Health-Related Quality of Life (HRQoL) Score for Children with Nephrotic Syndrome (N= 80)

Variable	Odds Ratio (OR)	95% Confidence Interval for OR		P value
		Lower	Upper
Gender	7.454	−3.907	18.816	0.195
Age group	−6.451	−11.490	−1.413	0.113
Origin	−1.438	−4.705	1.829	0.384
Phenotype of NS	0.669	−6.225	7.563	0.847
Histopathology	13.550	−4.226	31.326	0.130
Duration of illness	−9.531	−1.097	20.160	0.078
Degree of proteinuria	−7.285	−11.587	−2.984	0.001*
Hospital admission	−36.834	−24.847	−48.821	0.001*
Edema	−17.879	−7.889	−27.869	0.001*
Treatment	15.027	−0.882	30.936	0.064

Table 6 Baseline Demographic Data of Patients with Nephrotic Syndrome (Case Group) and Different Groups (Healthy Children, Children with Chronic Diseases, and Kidney Transplanted Children) (N =250)

Variable	Demographic Data	Number (Frequency %)
		Case Group (Children with NS) (N = 80)	Group 1 (Healthy Children) (N = 80)	Group 2 (Children with Chronic Diseases) (N = 65)	Group 3 (Kidney Transplanted Children) (N = 25)
Gender	Male	54 (67.5)	53 (66.3)	43 (66.1)	20 (80)
	Female	26 (32.5)	27 (33.8)	22 (33.8)	5 (20)
Age group	Toddler (2–4 years)	11 (13.8)	11 (13.8)	9 (13.8)	0 (0)
	Young Children (5–7 years)	18 (22.5)	18 (22.5)	15 (23.1)	0 (0)
	Children (8–12 years)	26 (32.5)	26 (32.5)	21 (32.3)	3 (12)
	Teens (13–18 years)	25 (31.3)	25 (31.3)	20 (30.7)	22 (88)

Table 7 HRQoL of Control Group 1 (Healthy Children) and Children with NS (Case Group)

HRQoL Domain	Groups	Number	Mean ± SD	P value
Physical	Nephrotic Syndrome	80	78.05 ± 29.01	0.001*
	Healthy group	80	95.55 ± 8.49
Emotional	Nephrotic Syndrome	80	80.88 ± 28.96	0.017*
	Healthy group	80	89.81 ± 15.82
Social	Nephrotic Syndrome	80	83.50 ± 27.89	0.001*
	Healthy group	80	97 ± 8.37
School	Nephrotic Syndrome	80	71.38 ± 27.79	0.001*
	Healthy group	80	92.98 ± 10.54
Total score	Nephrotic syndrome	80	78.46 ± 24.01	0.001*
	Healthy group	80	93.84 ± 8.11

Abbreviations: HRQoL, Health-related quality of life; SD, Standard deviation.

Table 8 HRQoL of Control Group 2 (Children with Chronic Diseases) and Children with NS (Case Group)

HRQoL Domain	Groups	Number	Mean ± SD	P value
Physical	Nephrotic syndrome	80	78.05 ± 29.01	0.066
	Chronic diseases	65	81.06 ± 24.20
Emotional	Nephrotic syndrome	80	80.88 ± 28.96	0.03*
	Chronic diseases	65	89.54 ± 18.30
Social	Nephrotic syndrome	80	83.50 ± 27.89	0.38
	Chronic diseases	65	87.08 ± 19.88
School	Nephrotic syndrome	80	71.38 ± 27.79	0.24
	Chronic diseases	65	76.87 ± 27.86
Total score	Nephrotic syndrome	80	78.45 ± 24.01	0.006*
	Chronic diseases	65	83.63 ± 17.76

Abbreviations: HRQoL, Health-related quality of life; SD, Standard deviation.

Table 9 HRQoL of Control Group 3 (Kidney Transplanted Children) and Children with NS (Case Group)

HRQoL Domain	Groups	Number	Mean ± SD	P value
Physical	Nephrotic syndrome	25	72.48 ± 28.45	0.001*
	Transplant group	25	79 ± 17.01
Emotional	Nephrotic syndrome	25	76.92 ± 29.67	0.154
	Transplant group	25	80.20 ± 24.13
Social	Nephrotic syndrome	25	81.92 ± 25.26	0.35
	Transplant group	25	81.80 ± 23.49
School	Nephrotic syndrome	25	63.46 ± 27.67	0.409
	Transplant group	25	67 ± 28.98
Total Score	Nephrotic syndrome	25	73.69 ± 21.39	0.091
	Transplant group	25	77 ± 16.31

Abbreviations: HRQoL, Health-related quality of life; SD, Standard deviation.