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. 2021 Aug;1(3):105-117.
doi: 10.1159/000516832. Epub 2021 Jun 24.

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

Jill R Krissberg  1 , Margaret E Helmuth  2 , Salem Almaani  3 , Yi Cai  4 , Daniel Cattran  5 , Debanjana Chatterjee  6 , Rasheed A Gbadegesin  7 , Keisha L Gibson  8 , Dorey A Glenn  8 , Laurence A Greenbaum  9 , Sandra Iragorri  10 , Koyal Jain  8 , Myda Khalid  11 , Jason M Kidd  12 , Jeffrey B Kopp  13 , Richard Lafayette  14 , Jordan G Nestor  6 , Rulan S Parekh  15 , Kimberly J Reidy  16 , David T Selewski  17 , C John Sperati  18 , Katherine R Tuttle  19 , Katherine Twombley  17 , Tetyana L Vasylyeva  20 , Donald Jack Weaver Jr  21 , Scott E Wenderfer  22 , Michelle M O'Shaughnessy  23
Affiliations

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

Jill R Krissberg et al. Glomerular Dis. 2021 Aug.

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.

Keywords: Disparities; Glomerular Disease; Pediatrics; Quality of Life; Race/Ethnicity.

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Conflict of interest statement

Conflicts of Interest: Dr. Greenbaum reports receiving research support from Vertex Pharmaceuticals, Apellis Pharmaceuticals, Reata Pharmaceuticals, Alexion Pharmaceuticals and an honorarium from Alexion Pharmaceuticals. Dr. Almaani is a consultant for Aurinia Pharmaceuticals Inc. Dr. Reidy is a primary investigator for Complexa and Advicenne studies unrelated to this current manuscript. Dr. Gibson holds advisory roles for Aurinia Inc., Reata Inc., and Retrophin, Inc. Dr. Tuttle has received research support from Goldfinch Bio and Travere/Retrophin and holds an advisory role for Goldfinch Bio. Dr. Sperati reports receiving research support for clinical trials from Alexion Pharmaceuticals and Alnylam, and honoraria for serving as chair of DSMB. All other authors declare that they have no known competing financial interests personal relationships that could appear to influence the work reported in this paper. Results of this paper have not been published previously in whole or part, with the exception of abstract format (ASN Kidney Week 2019).

Figures

Fig. 1
Fig. 1
Patient enrollment to CureGN and selection for inclusion in this current study. CureGN, Cure Glomerulonephropathy.
Fig. 2
Fig. 2
OR for missing work or school and betas for PROMIS scores in sequential regression models for adults. OR, odds ratio; PROMIS, Patient-Reported Outcomes Measurement Information System; CI, confidence interval.
Fig. 3
Fig. 3
OR for missing work or school and betas for PROMIS scores in sequential regression models for children. OR, odds ratio; PROMIS, Patient-Reported Outcomes Measurement Information System; CI, confidence interval.
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