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Abstract: TH-PO588

Mood Changes Associated with High-Dose Corticosteroids in Adults with Glomerular Disease

Session Information

Category: Glomerular Diseases

  • 1402 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

  • Daly, Fergus, University College Cork, Cork, Ireland
  • Stoneman, Sinead, University College Cork, Cork, Cork, Ireland
  • Clarkson, Michael, University College Cork, Cork, Cork, Ireland
  • O'Shaughnessy, Michelle M., University College Cork, Cork, Cork, Ireland
  • Moran, Sarah Margaret, University College Cork, Cork, Cork, Ireland

Group or Team Name

  • The Cork Kidney Research Group.
Background

Glomerulonephritis (GN) can be caused by a variety of underlying conditions, many of which are treated with high dose corticosteroids. There is a paucity of knowledge regarding the frequency, severity, and predictors of neuropsychiatric toxicity from high-dose corticosteroids in adults with glomerular diseases.

Methods

We conducted a prospective, survey-based study of adults with newly diagnosed or relapsing biopsy-proven minimal change disease (MCD), focal segmental glomerulosclerosis (FSGS), IgA nephropathy (IgAN), and membranous nephropathy (MN). Institutional ethical approval was granted.

Three identical questionnaires were provided for self-completion at enrolment, 2- & 12-weeks post-enrolment. The questionnaire was adapted from two existing surveys, developed and validated to measure mania (Altman Self-Rating Mania Scale) and depression (Patient Health Questionnaire – 9).

Results

30 patients were enrolled. Biopsy diagnoses included: MN (10), MCD (9), FSGS (4) and IgAN (7). 60% (18) were new diagnoses. 43% (13) had a prior psychiatric diagnosis (depression (8), anxiety (4), post traumatic stress disorder (1)) The median age was 54 years. There was no significant difference between groups in proteinuria or GFR at baseline level, however serum albumin was lower in the steroid treated group (25g/L vs 32g/L). 47% (14) of participants received corticosteroids, while the remainder(non-exposed: n=16) received no form of immunosuppressive therapy during their 12-weeks of enrolment.

Mania: ASRM scores at 2-weeks were significantly higher in the corticosteroid-exposed group compared to the immunosuppressant-naïve control group (p <0.001). Patients treated with corticosteroids experienced a mean ASRM score increase from baseline of 9 (standard deviation = 4.2) at 2-weeks, whereas their non-exposed counterparts
experienced a negligible change.

Depression: A significant between-group difference in PHQ-9 (depression) scores at 12-weeks was observed with the corticosteroid group recording higher scores (p < 0.001).

Conclusion

Patients with glomerular disease treated with corticosteroids experienced significant increases in mania scores at early stages of their treatment course, while depression predominated at later stages of treatment course.

Funding

  • Clinical Revenue Support