Proteinuria Is Associated with Quality of Life and Depression in Adults with Primary Glomerulopathy and Preserved Renal Function

BACKGROUND: There is no information about HRQoL, depression and associated factors in adult with nephrotic syndrome-associated glomerulopathy. METHODOLOGY/PRINCIPAL FINDINGS: Patients 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/SIGNIFICANCE: Nephrotic-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

Scores in subgroups based on several clinical characteristics.

<p>PCS: SF-36 Physical composite score; MCS: SF-36 Mental composite score; HAMD: Hamilton Depression Rating Scale; CsA: cyclosporine.</p

SF-36 HRQoL and HAMD comparison between glomerulopathy and hemodialysis patients and healthy subjects.

<p>#p<0.001 between all groups,</p>*<p>p<0.001 between healthy subjects and others groups,</p>**<p>p<0.01 between glomerulopathy patients and others groups,</p>∂<p>p = 0.01 between glomerulopathy patients vs. healthy subjects.</p

Patients' clinical and demographic characteristics. Data are presented as mean±SD or absolute values.

<p>FSGS: focal and segmentar glomerulosclerosis; ML: minimal lesions; MN: membranous Nephropathy; IgAN: IgA nephropathy; MPGN: membranoproliferative Glomerulonephritis; CKD: Chronic Kidney Disease; ACE: angiotensin converting enzyme; AT1R: angiotensin 1 receptor.</p

Variables independently associated with PCS, MCS and HAMD score.

<p>Variables independently associated with PCS, MCS and HAMD score.</p

Significant correlations (<i>r</i>_s) between PCS, MCS and HAMD score with clinical and laboratory data.

<p>Significant correlations (<i>r</i>_s) between PCS, MCS and HAMD score with clinical and laboratory data.</p