Abstract
The objective of our study was to assess the psychologic and economic effects of pediatric nephrotic syndrome (NS) on caregivers. Caregivers of 50 children with NS were compared with a control group of 50 families of children with minor illnesses attending the same outpatient facility. Beck’s Depression Inventory (BDI) IA was used to assess the mental status of the primary caregiver. The socioeconomic status of the family was assessed using the modified Kuppuswamy scale. Expenditure for the illness was calculated during parent interviews. The difference between groups was analyzed using analysis of variance (ANOVA) and Duncan’s multiple range test. BDI scores signified moderate to severe depression in 48% of NS caregivers compared with 12% controls. The mean BDI score was significantly higher in NS caregivers, correlating positively with disease severity and negatively with socioeconomic status. Expenditure for disease also was significantly higher in families with NS patients, varying between 30% and 60% of monthly income depending on disease severity compared with 6.9% in controls. In 10% of NS families, it was more than total income, forcing families to break into savings or go into debt. Although pediatric NS most commonly has an excellent long-term outcome, it causes significant mental and economic stress on families. Severe forms should be categorized as a chronic illness and be eligible for disability benefits and subsidized travel and medical care. Establishing support groups and supportive care at local levels would help reduce the burden on families of patients wtih NS.
Similar content being viewed by others
References
Tarshish P, Tobin JN, Bernstein J, Edelman CM (1997) Prognostic significance of the early course of minimal change nephrotic syndrome: Report of the International Study of Kidney Disease in Children. J Am Soc Nephrol 8:769–776
Bagga A, Ali U, Banerjee S, Kanitkar M, Phadke KD, Senguttuvan P, Sethi S, Shah M (2008) Management of steroid sensitive nephrotic syndrome: revised guidelines. Indian Pediatric Nephrology Group, Indian Academy of Pediatrics. Indian Pediatr 45:203–214
Gordillo R, Spitzer A (2009) The Nephrotic Syndrome. Pediatr Rev 30:94–105
Niaudet P (2009) Long-term outcome of children with steroid-sensitive idiopathic nephrotic syndrome. Clin J Am Soc Nephrol 4:1547–1548
Neuhaus TJ, Langlois V, Licht C (2010) Behavioral abnormalities in children with nephrotic syndrome - an under appreciated complication of a standard treatment? Nephrol Dial Transplant 25:2397–2399
Gulati A, Bagga A, Gulati S, Mehta KP, Vijayakumar M (2009) Management of steroid resistant nephrotic syndrome. Indian Society of Pediatric Nephrology. Indian Pediatr 46:35–47
Mehta M, Bagga A, Pande P, Bajaj G, Srivastava RN (1995) Behavior problems in nephrotic syndrome. Indian Pediatr 32:1281–1286
Rüth EM, Landolt MA, Kemper MJ, Neuhaus TJ (2004) Health-related quality of life (QOL) and psychosocial adjustment in children with steroid-sensitive nephrotic syndrome (SSNS). J Pediatr 145:778–783
Groth-Marnat G (2003) The Beck Depression Inventory. In: The handbook of psychological assessment, 4th edn. Publishers: John Wiley and Sons, Hoboken, NY, pp 587–588
Basu S, Chattopadhyay D, Deb A, Ash S, Samajder J, Deb Z, Basu S (1995) Adoption of Beck Depression Inventory into Bengali and its clinical validity. Bulletin of Indian Psychiatric Society 5:5–9
Kumar N, Shekhar C, Kumar P, Kund AS (2007) Kuppuswamy's Socioeconomic Status Scale-Updating for 2007. Indian J Pediatr 74:1131–1132
Tsai TC, Liu SI, Tsai JD, Chou LH (2006) Psychosocial effects on caregivers for children on chronic peritoneal dialysis. Kidney Int 70:1893–1894
Reynolds JM, Garralda ME, Jameson RA, Postlethwaite RJ (1988) How parents and families cope with chronic renal failure. Arch Dis Child 63:821–826
McKenna AM, Keating LE, Vigneux A, Stevens S, Williams A, Geary DF (2006) Quality of life in children with chronic kidney disease - patient and caregiver assessments. Nephrol Dial Transplant 21:1899–1905
Mekahli D, Liutkus A, Ranchin B, Yu A, Bessenay L, Girardin E, Van Damme-Lombaerts R, Palcoux JB, Cachat F, Lavocat MP, Bourdat-Michel G, Nobili F, Cochat P (2009) Long-term outcome of idiopathic steroid-resistant nephrotic syndrome: a multicenter study. Pediatr Nephrol 24:1525–1532
Fakhouri F, Bocquet N, Taupin P, Presne C, Gagnadoux MF, Landais P, Lesavre P, Chauveau D, Knebelmann B, Broyer M, Grünfeld JP, Niaudet P (2003) Steroid-sensitive nephrotic syndrome: From childhood to adulthood. Am J Kidney Dis 41:550–557
Guha P, De A, Ghosal M (2009) Behavior profile of children with nephrotic syndrome. Indian J Psychiatry 2:122–126
Mishra OP, Basu B, Upadhyay SK, Prasad R, Schaefer F (2010) Behavioral abnormalities in children with nephrotic syndrome. Nephrol Dial Transplant 25:2537–2541
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Mitra, S., Banerjee, S. The impact of pediatric nephrotic syndrome on families. Pediatr Nephrol 26, 1235–1240 (2011). https://doi.org/10.1007/s00467-011-1841-x
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00467-011-1841-x