493 - Effect of Mental Health on Outcomes in Pediatric Glomerular Disease Within the Cure Glomerulonephropathy (CureGN) Study

Publication Number: 2479.493

Mahie Abdullah, Cohen Children's Medical Center, New Hyde Park, NY, United States; Emily Kim, University of Michigan Medical School, Rochester Hills, MI, United States; Caroline Smerdon, University of Michigan Medical School, Ann Arbor, MI, United States; Katelyn Kostelyk, The IgA Nephropathy Foundation, Mims, FL, United States; Laura Mariani, University of Michigan Medical School, Ann Arbor, MI, United States; Christine Sethna, Cohen Children's Medical Center, New Hyde Park, NY, United States

Background: The relationship between mental health and pediatric glomerular disease is understudied.

Objective: This study assessed the prevalence of mental health diagnoses in children with a glomerular disease diagnosis and their impact on clinical outcomes.

Design/Methods: A longitudinal analysis included visits from children aged 0-17 years with proteinuric glomerulopathies enrolled in the Cure Glomerulonephropathy (CureGN) study. Descriptive statistics evaluated the prevalence of mental health diagnosis (depression, anxiety, ADHD or bipolar disorder) at enrollment and characterized Patient-Reported Outcomes Measurement Information System (PROMIS) depressive symptom scores. Generalized estimating equations (GEE) models identified predictors of PROMIS depressive symptom scores. Cox proportional hazards models adjusted for glomerular diagnosis, age at biopsy, sex, race/ethnicity, insurance type, glomerular filtration rate, urine protein/creatinine, maternal education, immunosuppression and edema were used to determine the association of mental health diagnosis and PROMIS scores with kidney failure.

Results: Among 997 participants (9.03±4.55 yr, 58% M), 246 (25%) had a mental health diagnosis at enrollment. Participants with a diagnosis were older, more likely to be female, and had a higher eGFR (p < 0.05). In GEE models, mental health diagnosis, female sex and edema were significantly associated with higher PROMIS depressive symptoms scores (indicating worse mental health) over time (p < 0.001) (Table 1). Mental health diagnosis and PROMIS depressive scores were not significantly associated with kidney failure in adjusted Cox regression models.

Conclusion(s): In CureGN, mental health outcomes were common in pediatric patients with glomerular disease and linked to worsening depressive symptoms over time, but not associated with kidney failure. These results highlight the importance of integrating mental health support into pediatric care.

Table 1. Generalized Estimating Equations of PROMIS Depressive Symptoms Score in Relation to Exposure
Models were adjusted for years post-enrollment. Other insurance defined as any insurance other than Private, Medicare, Medicaid, Military/VA, and Other govt (Non-US)