#1709 Longitudinal follow-up of health-related quality of life indicators in glomerulonephritis treated with immunosuppressants

Abstract Background and Aims Glomerulonephritis is a major cause of chronic kidney disease, especially among young adults. Patient-reported outcome measures (PROMs) can allow nephrologists to understand and address patients’ perceptions of their health. We aimed to describe the patient-reported health-related quality of life (HRQOL) indices and their determinants among patients with active glomerulonephritis during their follow-up. Method This prospective cohort study included adults with active glomerulonephritis enrolled and followed-up between July 2020 and July 2021 at the Glomerulonephritis Disease Management Clinics, Singapore General Hospital. HRQOL was assessed at enrolment (baseline) and every 3 months for a year using interviewer-administered surveys: the patient reported outcome measurement informative system (PROMIS) and Short-Form Health Survey (SF-36). Socio-demographic and clinical data were collected from patient interviews and medical records. Longitudinal changes in HRQOL indices between baseline and Month 3 were analysed using a mixed-effects model incorporating time and adjusting for age, kidney function, and the Charlson Comorbidity Index. Results Sixty participants (mean age 45 ± 16 years) were enrolled. The most common diagnoses were primary podocytopathies (33%) and lupus nephritis (25%). The most common immunosuppressive therapies were prednisolone (65%), mycophenolate mofetil or sodium (47%) and calcineurin inhibitors (40%). The baseline, Month 3, Month 6, Month 9 and Month 12 surveys were completed by 60, 47, 27, 16, and 16 participants, respectively. Mixed-effects analysis for changes in PROMIS domain scores over time found that the presence of oedema was associated with increased anxiety scores (β = 0.728, P = 0.03). Changes in the type of immunosuppressants reduced sleep disturbance scores (β = −0.663, P = 0.03). In the analyses for changes in SF-36 domain scores over time, higher serum albumin levels were associated with improved physical functioning scores (β = 11.7, P = 0.04), while changes in the type of immunosuppressants improved social functioning scores (β = 17.1, P = 0.003). Conclusion Patient-reported HRQOL change during glomerulonephritis follow-up and treatment. PROMs can be integrated with individualized clinical care e.g. monitor for impact of therapeutic manoeuvres to address the physical, psychological, and social domains of HRQOL. Future studies should explore interventions to mitigate the psychological and functional burden experienced by patients with glomerulonephritis and evaluate the long-term impact of PROMs-driven care on patient outcomes.