ABSTRACT
INTRODUCTION: Mental health problems, such as anxiety, depression, and ineffective family coping, in children with lupus nephritis (LN) can increase the severity and affect the management of the disease, thus affecting the quality of life (QoL) of patients. OBJECTIVE: Analyzing the association between levels of depression, anxiety, coping, disease activity on the QoL of pediatric patients with LN. PATIENTS AND METHODS: There were 62 pediatric LN participants (16 participants in the induction phase and 46 participants in the maintenance phase). Participants were measured for anxiety, depression, coping, disease activity (systemic lupus erythematosus disease activity index/SLEDAI), and QoL. The measurement results were compared between induction and maintenance groups. Analysis of the association between anxiety, depression, coping, and disease activity with the QoL of children with LN used a multiple logistic regression test with p <0.05. RESULTS: The measurement results obtained anxiety (induction = 69.06±3.92 and maintenance = 45.24±10.33; p <0.001), depression (induction = 69.88±3.34 and maintenance = 42.20±9.12; p <0.001), coping (induction = 99.88±12.93 and maintenance = 115.67±7.34; p <0.001), SLEDAI (induction = 15.81±12.58 and maintenance = 0.43±1.26; p <0.001), and QoL (induction = 49.92±12.44 and maintenance = 88.15±8.06; p <0.001).. Anxiety level in the induction group (p = 0.043) and maintenance group (p <0.001; p = 0.032; p = 0.008; p = 0.009). Depression level in the induction group (p = 0.031) and maintenance group (p = 0.024; p = 0.042; p = 0.003). SLEDAI score in the maintenance group (p = 0.003; p = 0.003). Coping in induction group (p = 0.016; p = 0.016) and maintenance group (p = 0.005). CONCLUSION: Mental health disorders reduce the QoL of LN children, and the level of QoL in induction phase is lower than maintenance phase.
ABSTRACT
The objective of this study was to identify predictors of relapse and determine the predictive score for relapse in steroid-sensitive nephrotic syndrome. Ninety-nine children with nephrotic syndrome visiting the pediatric nephrology outpatient clinic of Soetomo Hospital from 1983 to 2001 were studied. There were 63 children with relapses (50 infrequent relapses, 13 frequent relapses) and 36 children without a relapse for at least 1 year after beginning steroid treatment, which served as a control group. The selected variables were grouped into non-renal factors (age, sex, nutritional status, infection) and renal factors (histopathologic findings, hypertension, hematuria, azotemia, hypocomplementemia, rapidity of early steroid response, number of relapses within the first 6 months, time-interval between early steroid response and first relapse). Using the discriminant analysis function test, it was found that the statistically significant predictors of relapse were the time-interval between early steroid response and the first relapse, number of relapses within the first 6 months, infection during the first relapse, hematuria and sex. A prediction score can be determined using 3, 5 or 6 parameters by including the rapidity of early steroid response.
