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The longitudinal relationship between patient-reported outcomes and clinical characteristics among patients with focal segmental glomerulosclerosis in the Nephrotic Syndrome Study Network

2019; Oxford University Press; Volume: 13; Issue: 4 Linguagem: Inglês

10.1093/ckj/sfz092

2048-8513

Jonathan P. Troost, Anne Waldo, Noelle E. Carlozzi, Shannon L. Murphy, Frank Modersitzki, Howard Trachtman, Patrick H. Nachman, Kimberly Reidy, David T. Selewski, Emily Herreshoff, Tarak Srivastava, Keisha Gibson, Vimal K. Derebail, Jen Jar Lin, Sangeeta Hingorani, Alessia Fornoni, Fernando C. Fervenza, Kamalanathan K. Sambandam, Ambarish M. Athavale, Jeffrey B. Kopp, Heather N. Reich, Sharon G. Adler, Larry A. Greenbaum, Katherine M. Dell, Gerald B. Appel, Chia-shi Wang, John R. Sedor, Frederick J. Kaskel, Richard A. Lafayette, Meredith A. Atkinson, John C. Lieske, Christine B. Sethna, Matthias Kretzler, Michelle Hladunewich, Kevin V. Lemley, Elizabeth Brown, Kevin Meyers, Crystal A. Gadegbeku, Lawrence B. Holzman, Jonathan Ashley Jefferson, Katherine R. Tuttle, Pamela Singer, Marie C. Hogan, Daniel C. Cattran, Laura Barisoni, Debbie S. Gipson, John R. Sedor, Katherine M. Dell, M. Schachere, Kevin V. Lemley, L Whitted, Tarak Srivastava, Connie J Haney, Christine B. Sethna, Sayuri Gurusinghe, Gerald B. Appel, Michael Toledo, Larry A. Greenbaum, C Wang, Bomee Lee, Sharon G. Adler, Cynthia C. Nast, John Page, John H. Stroger, Ambarish M. Athavale, M. Itteera, Alicia M. Neu, Sara A. Boynton, Fernando C. Fervenza, Marie C. Hogan, John C. Lieske, Vladimir Chernitskiy, Frederick J. Kaskel, Kimberly Reidy, Jeffrey B. Kopp, E Castro-Rubio, Emily Brede, J. Thomas Blake, Howard Trachtman, Olga Zhdanova, Frank Modersitzki, Sandro Vento, Richard A. Lafayette, K. Mehta, Crystal A. Gadegbeku, Duncan B. Johnstone, Zoe Pfeffer, Daniel C. Cattran, Michelle Hladunewich, Heather N. Reich, P. Ling, Martin Romano, Alessia Fornoni, Laura Barisoni, Carlos Bidot, Matthias Kretzler, Debbie S. Gipson, Anna Williams, Renée Pitter, Vimal K. Derebail, Keisha Gibson, S Grubbs, Anne Froment, Lawrence B. Holzman, Kevin Meyers, K. Kallem, Fumei Cerecino, Kamalanathan K. Sambandam, Elizabeth Brown, N Johnson, A. Jefferson, Sangeeta Hingorani, Katherine R. Tuttle, K Klepach, M Kelton, Ann Cooper, Barry I. Freedman, J.J. Lin, Mitzie Spainhour, S Gray, Matthias Kretzler, Laura Barisoni, Crystal A. Gadegbeku, Brenda W. Gillespie, Debbie S. Gipson, Lawrence B. Holzman, Laura Mariani, Matthew G. Sampson, Peter X.‐K. Song, Jonathan P. Troost, Jarcy Zee, Emily Herreshoff, Colleen Kincaid, Chrysta Lienczewski, T. Mainieri, Anna Williams, Carmen Ávila-Casado, Serena M. Bagnasco, Joseph P. Gaut, Stephen M. Hewitt, Jeffrey B. Hodgin, Kevin V. Lemley, Laura Mariani, Matthew Palmer, Avi Z. Rosenberg, Virginie Royal, D. Thomas, Jarcy Zee, Laura Barisoni, Cynthia C. Nast, Kevin C. Abbott, Cindy N. Roy, Tiina K. Urv, Philip J. Brooks, John R. Sedor, Katherine M. Dell, M. Schachere, Kevin V. Lemley, L Whitted, Tarak Srivastava, Connie J Haney, Christine B. Sethna, Sayuri Gurusinghe, Gerald B. Appel, Michael Toledo, Larry A. Greenbaum, C Wang, Bomee Lee, Sharon G. Adler, Cynthia C. Nast, John Page, John H. Stroger, Ambarish M. Athavale, M. Itteera, Alicia M. Neu, Sara A. Boynton, Fernando C. Fervenza, Marie C. Hogan, John C. Lieske, Vladimir Chernitskiy, Frederick J. Kaskel, Kimberly Reidy, Jeffrey B. Kopp, E Castro-Rubio, Emily Brede, J. Thomas Blake, Howard Trachtman, Olga Zhdanova, Frank Modersitzki, Sandro Vento, Richard A. Lafayette, K. Mehta, Crystal A. Gadegbeku, Duncan B. Johnstone, Zoe Pfeffer, Daniel C. Cattran, Michelle Hladunewich, Heather N. Reich, P. Ling, Martin Romano, Alessia Fornoni, Laura Barisoni, Carlos Bidot, Matthias Kretzler, Debbie S. Gipson, Anna Williams, Renée Pitter, Vimal K. Derebail, Keisha Gibson, S Grubbs, Anne Froment, Lawrence B. Holzman, Kevin Meyers, K. Kallem, Fumei Cerecino, Kamalanathan K. Sambandam, Elizabeth Brown, N Johnson, A. Jefferson, Sangeeta Hingorani, Katherine R. Tuttle, K Klepach, M Kelton, Ann Cooper, Barry I. Freedman, J.J. Lin, Mitzie Spainhour, S Gray, Matthias Kretzler, Laura Barisoni, Crystal A. Gadegbeku, Brenda W. Gillespie, Debbie S. Gipson, Lawrence B. Holzman, Laura Mariani, Matthew G. Sampson, Peter X.‐K. Song, Jonathan P. Troost, Jarcy Zee, Emily Herreshoff, Colleen Kincaid, Chrysta Lienczewski, T. Mainieri, Anna Williams, Carmen Ávila-Casado, Serena M. Bagnasco, Joseph P. Gaut, Stephen M. Hewitt, Jeffrey B. Hodgin, Kevin V. Lemley, Laura Mariani, Matthew Palmer, Avi Z. Rosenberg, Virginie Royal, D. Thomas, Jarcy Zee, Laura Barisoni, Cynthia C. Nast, Kevin C. Abbott, Cindy N. Roy, Tiina K. Urv, Philip J. Brooks,

Chronic Kidney Disease and Diabetes

Understanding the relationship between clinical and patient-reported outcomes (PROs) will help support clinical care and future clinical trial design of novel therapies for focal segmental glomerulosclerosis (FSGS).FSGS patients ≥8 years of age enrolled in the Nephrotic Syndrome Study Network completed Patient-Reported Outcomes Measurement Information System PRO measures of health-related quality of life (HRQoL) (children: global health, mobility, fatigue, pain interference, depression, anxiety, stress and peer relationships; adults: physical functioning, fatigue, pain interference, sleep impairment, mental health, depression, anxiety and social satisfaction) at baseline and during longitudinal follow-up for a maximum of 5 years. Linear mixed-effects models were used to determine which demographic, clinical and laboratory features were associated with PROs for each of the eight children and eight adults studied.There were 45 children and 114 adult FSGS patients enrolled that had at least one PRO assessment and 519 patient visits. Multivariable analyses among children found that edema was associated with global health (-7.6 points, P = 0.02) and mobility (-4.2, P = 0.02), the number of reported symptoms was associated with worse depression (-2.7 per symptom, P = 0.009) and anxiety (-2.3, P = 0.02) and the number of emergency room (ER) visits in the prior 6 months was associated with worse mobility (-2.8 per visit, P < 0.001) and fatigue (-2.4, P = 0.03). Multivariable analyses among adults found the number of reported symptoms was associated with worse function in all eight PROMIS measures and the number of ER visits was associated with worse fatigue, pain interference, sleep impairment, depression, anxiety and social satisfaction. Laboratory markers of disease severity (i.e. proteinuria, estimated glomerular filtration rate and serum albumin) did not predict PRO in multivariable analyses, with the single exception of complete remission and better pain interference scores among children (+9.3, P = 0.03).PROs provide important information about HRQoL for persons with FSGS that is not captured solely by the examination of laboratory-based markers of disease. However, it is critical that instruments capture the patient experience and FSGS clinical trials may benefit from a disease-specific instrument more sensitive to within-patient changes.