الفهرس 
Nephrotic syndromeOnly 14 pages are availabe for public view
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Abstract
The estimation of health related quality of life (HRQOL) in children and adolescents has received increasing attention in pediatrics and adolescent health care, and several instruments/questionnaires are now available for use in these populations. The optimal care and proper assessment of the health of children with nephrotic syndrome (NS) can be achieved if the personal perception of the state of their health is also taken into account.
The study aimed to assess the HRQOL in children with NS in the pediatric nephrology clinic of Menoufia university hospital to determine factors affecting HRQOL in these children. Forty children aging 2 to 15 years with NS who were steroid sensitive, steroid dependent and steroid resistant with one time relapse or two times or frequent relapses were enrolled in this study.
All of them were subjected to full history taking, complete physical examination, and laboratory investigations as serum albumin, cholesterol level, and 24hr urinary protein.
All the patients were also subjected to the PedsQL TM questionnaire CKD Module. It consists of 34 questions grouped into seven items comprising health-related perception in the areas of general fatigue, kidney disease, treatment, interaction with family and friends, worry, physical appearance, and communication.
Our results revealed that about quality of life (QOL) of our patients. Regarding the total score of QOL, the mean score was 59.1±7.39 (±Sd). The best scores in our study were in the domains of ”communication” and ”family and peer interaction’’.
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Many variables are affecting the total score of QOL: gender, duration of the disease, socioeconomic level, presence or absence of edema, hypertension and number of relapses.
Gender did not affect the QOL as the mean total score was statistically insignificant.
On the other hand, we found that age affected the total score of QOL, as there was a negative relationship between age and QOL. R was -0.376 with a significant statistical test this meant; the youngest children had better QOL.
Also, the duration of the disease affected the total score of QOL with a negative relationship (R was -0.761) with a highly significant statistical test. As the longest duration, the worst QOL
We found that edema affected the total score QOL as children without edema had better QOL as the mean was 66.56.
Hypertension one of the factors that affected the total score QOL, children without hypertension had a better QOL, as the mean was 63.75.
At the last,the number of relapses affected the total score QOL, children with one time relapse had better QOL rather than two time relapses nor frequent relapses with a mean 64.62.
Regarding General Fatigue, in our study, the mean score was 57.03. It was affected by sociecconmic state (SES), edema, hypertension, and the number of relapses as the mean was 60.06, 65.25, 63.65, and 64.98 respectively which are statistically significant.
As regards About My Kidney Disease, in our study, the mean score was 53.87. It was affected by hypertension and the number
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of relapses as the mean was 60.93 and 61.33 respectively with a significant statistical test.
In our study, the mean score for Treatment Problems was 66.56. It was affected by SES, hypertension, and the number of relapses as the mean were 67.36, 73.04, and 81.25 respectively with a significant statistical test.
Regarding Family and Peer interaction, in our study, the mean score was 82.29. Gender was the only factor affecting this domain as females had better QOL than males as the mean was 90.91 with a significant statistical test.
As regards Worry, the analysis of the result of the present study revealed that the mean score was 21.037. It was affected by edema, hypertension, and the number of relapses as the mean were 31.33, 55.103, and 32.97 respectively with a significant statistical test.
In our study, the mean score for perceived physical appearance was 42.6. This domain was affected by SES, edema, hypertension, and number of relapses as the mean was 49.29, 58.33, 55.103, and 59.33 respectively with a significant statistical test.
As regard Communication, in our study, the mean score was 93 and no factors were affecting this scale.
At last, we do a Comparison between PedsQL quality of life domains and different clinical phenotypes of nephrotic syndrome.
In General Fatigue domain steroid sensitive NS had better QOL than the other two types (steroid dependent and steroid resistant) as the mean was 67.5 with a significant statistical test.
Regarding About My Kidney Disease, Treatment problems, Family Peer Interaction, and Communication domains; in our
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study the mean of steroid sensitive NS was 61, 72.5, 85.83, and 94.5 respectively but with insignificant statistical test.
In Worry domain steroid sensitive NS had better QOL than the other two types as the mean was 34.75 with a significant statistical test.
According to Perceived Physical Appearance domain steroid sensitive had a better QOL than the other two types as the mean was 58.33 with a significant statistical test.
Finally, according to the total score QOL steroid sensitive had a better QOL rather than steroid neither dependent nor resistant as the mean was 65.27 with a significant statistical test.