Racial-ethnic differences in health-related quality of life among adults and children with glomerular disease.

• Authors: Jill R Krissberg, Division of Nephrology, Department of Pediatrics, Stanford University, Stanford, California, United States.; Margaret E Helmuth, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States.; Salem Almaani, Department of Nephrology, The Ohio State University, Columbus, Ohio, United States.; Yi Cai, Division of Pediatric Nephrology, Helen DeVos Children's Hospital, Grand Rapids, Michigan, United States.; Daniel Cattran, Division of Nephrology, University Health Network, University of Toronto, Ontario, Canada.; Debanjana Chatterjee, Division of Nephrology, Department of Medicine, Columbia University Medical Center, New York, New York, United States.; Rasheed A Gbadegesin, Department of Pediatrics, Duke University, Durham, North Carolina, United States.; Keisha L Gibson, Division of Nephrology and Hypertension, University of North Carolina, Chapel Hill, North Carolina, United States.; Dorey A Glenn, Division of Nephrology and Hypertension, University of North Carolina, Chapel Hill, North Carolina, United States.; Laurence A Greenbaum, Emory University; Sandra Iragorri, Division of Nephrology and Hypertension, Department of Pediatrics, Oregon Health and Science University, Portland, Oregon, United States.; Koyal Jain, Division of Nephrology and Hypertension, University of North Carolina, Chapel Hill, North Carolina, United States.; Myda Khalid, Division of Nephrology, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, United States.; Jason M Kidd, Division of Nephrology, Virginia Commonwealth University, Richmond, Virginia, United States.; Jeffrey B Kopp, Kidney Disease Section, Kidney Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, United States.; Richard Lafayette, Division of Nephrology and Hypertension, Stanford University, Stanford, California, United States.; Jordan G Nestor, Division of Nephrology, Department of Medicine, Columbia University Medical Center, New York, New York, United States.; Rulan S Parekh, Division of Nephrology, Department of Paediatrics, Hospital for Sick Children, University Health Network and University of Toronto, Toronto, Canada.; Kimberly J Reidy, Department of Pediatric Nephrology, Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, New York, United States.; David T Selewski, Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina, United States.; C John Sperati, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States.; Katherine R Tuttle, Division of Nephrology, University of Washington, Seattle, Washington, United States.; Katherine Twombley, Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina, United States.; Tetyana L Vasylyeva, Division of Nephrology, Department of Pediatrics, Texas Tech University Health Sciences Center, Lubbock, Texas, United States.; Donald Jack Weaver, Division of Pediatric Nephrology, Atrium Health Levine Children's, Charlotte, North Carolina, United States.; Scott E Wenderfer, Pediatric Nephrology, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, United States.; Michelle M O'Shaughnessy, Department of Renal Medicine, Cork University Hospital and University College Cork, Cork, Ireland.
• Journal Title: Glomerular Dis
• Volume: Volume 1, Number 3
• Publisher: S. Karger AG, Basel | 2021-08, Pages 105-117
• Type of Work: Article | Post-print: After Peer Review
• Publisher DOI: http://doi.org/10.1159/000516832
• Subjects: Health Sciences, Pathology; Health Sciences, Medicine and Surgery
• Keywords: Disparities; Glomerular Disease; Pediatrics; Quality of Life; Race/Ethnicity

Abstract

INTRODUCTION: Disparities in health-related quality of life (HRQOL) have been inadequately studied in patients with glomerular disease. The aim of this study was to identify relationships between race/ethnicity, socioeconomic status, disease severity, and HRQOL in an ethnically and racially diverse cohort of patients with glomerular disease. METHODS: Cure Glomerulonephropathy (CureGN) is a multinational cohort study of patients with biopsy-proven glomerular disease. Associations between race/ethnicity and HRQOL were determined by the following: 1. Missed school or work due to kidney disease; 2. Responses to Patient Reported Outcomes Measurement Information System (PROMIS) questionnaires. We adjusted for demographics, socioeconomic status, and disease characteristics using multivariable logistic and linear regression. RESULTS: Black and Hispanic participants had worse socioeconomic status and more severe glomerular disease than White or Asian participants. Black adults missed work or school most frequently due to kidney disease (30% versus 16-23% in the other three groups, p=0.04), and had the worst self-reported global physical health (median score 44.1 versus 48.0-48.2, p<0.001) and fatigue (53.8 versus 48.5-51.1, p=0.002), compared to other racial/ethnic groups. However, these findings were not statistically significant with adjustment for socioeconomic status and disease severity, both of which were strongly associated with HRQOL in adults. Among children, disease severity but not race/ethnicity or socioeconomic status were associated with HRQOL. CONCLUSIONS: Among patients with glomerular disease enrolled in CureGN, the worse HRQOL reported by Black adults was attributable to lower socioeconomic status and more severe glomerular disease. No racial/ethnic differences in HRQOL were observed in children.