Abstract: TH-PO1051
Mood, Anxiety, and Hyperactivity Disorders in Patients with Glomerular Disease
Session Information
- Glomerular Diseases: Epidemiology, Mechanisms, Complications, Outcomes
November 07, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Glomerular Diseases
- 1203 Glomerular Diseases: Clinical, Outcomes, and Trials
Authors
- Desmond, Hailey, University of Michigan, Ann Arbor, Michigan, United States
- Waldo, Anne, University of Michigan, Ann Arbor, Michigan, United States
- Callaway, Andi J., The Nephrotic Syndrome Foundation, Alamo, California, United States
- Gipson, Patrick E., University of Michigan, Ann Arbor, Michigan, United States
- Oh, Gia J., Randall Children's at Legacy Emanuel, Portland, Oregon, United States
- O'Shaughnessy, Michelle M., Stanford University, Palo Alto, California, United States
- Modes, Meg, Patient Advocate, Livonia, Michigan, United States
- Elliott, Matthew, Metrolina Nephrology Associates, Charlotte, North Carolina, United States
- Adler, Sharon G., Harbor-UCLA Medical Center, Torrance, California, United States
- Pesenson, Anne, The Polyclinic, Seattle, Washington, United States
- Selewski, David T., Medical University of South Carolina, Charleston, South Carolina, United States
- Carlozzi, Noelle E., University of Michigan, Ann Arbor, Michigan, United States
- Kamil, Elaine S., Cedars-Sinai Medical Center, Los Angeles, California, United States
- Gipson, Debbie S., University of Michigan, Ann Arbor, Michigan, United States
- Massengill, Susan F., Levine Children's Hospital, Charlotte, North Carolina, United States
Background
Patients with chronic health conditions are at heightened risk for psychiatric disorders; yet in glomerular disease (GD) little is known about the prevalence of mood, anxiety, and hyperactivity disorders or associations with patient and disease characteristics.
Methods
This study included patients with GD enrolled in the Kidney Research Network multisite patient registry. Encounter, diagnosis, medication, lab, and vital sign data are extracted monthly from participants’ electronic health records. ICD9/10 diagnosis codes were used to identify psychiatric disorders, including anxiety and depressive disorders and attention deficit disorder (ADD). Longitudinal GEE models were used to analyze the odds of being diagnosed with a psychiatric disorder. Potential covariates in the models included age at kidney disease onset, sex, race, ethnicity, and time-varying treatment, eGFR and urine protein:creatinine ratio (UP:C). Continuous variables are presented as median (IQR).
Results
Data were available for 938 patients with a 51 (IQR: 25-92) month follow up and kidney disease onset age of 19 (IQR: 5-41) yrs. 202 (21.5%) were diagnosed with a psychiatric disorder at a rate of 4.3 per 100 pt-yrs, with 78 of those having two or more disorders. The most common disorders were anxiety (n=145, 3.1 per 100 pt-yrs), depression (n=101, 2.1 per 100 pt-yrs), and ADD (n=29, 0.6 per 100 pt-yrs). Adolescents vs adults (OR: 2.4, 95% CI: 1.5-4.0), white vs Asian race (OR: 2.7, 95% CI: 1.3-5.6), steroid treatment (OR: 2.5, 95% CI: 1.4-3.8) and higher UP:C (OR per log: 1.2, 95% CI: 1.0-1.3) were significantly associated with psychiatric disorder diagnosis.
Conclusion
Select psychiatric disorders were documented in approximately one quarter of patients with GD and were associated with adolescence (vs adulthood), steroid therapy, higher proteinuria, and white (vs Asian) race. This may be an underrepresentation as data is based on what was documented in participants' electronic health record. A difference in prevalence by race may suggest a difference in assessment and diagnosis rather than true difference in prevalence. These findings suggest mental health screening may be warranted in patients with GD.
Funding
- Private Foundation Support