Psychosocial and cognitive function in children with nephrotic syndrome: association with disease and treatment variables

BACKGROUND To investigate possible differences in emotional/behavioral problems and cognitive function in children with nephrotic syndrome compared to healthy controls and to examine the effect of disease-specific and steroid treatment-specific characteristics on the abovementioned variables. METHODS Forty-one patients with nephrotic syndrome (23 boys, age range: 4.4-15.2 years) and 42 sex- and age-matched healthy control subjects (20 boys, age range: 4.1-13.4 years) were enrolled in the study. Disease (severity, age of diagnosis, duration) and steroid treatment (total duration, present methylprednisolone dose and duration of present dose) data were collected. In order to assess children's emotional/behavioral problems, the Child Behavior Checklist was administered. The Wechsler Intelligence Scale for Children - Third Edition was administered to assess Full-Scale, Verbal, and Performance intelligence quotient (IQ) scores. RESULTS The patients presented with more internalizing problems (P = 0.015), including withdrawal (P = 0.012) and somatic complaints (P = 0 .011), but not more anxiety/depression or externalizing problems. A significant association was found between severity of disease and somatic complaints (P = 0.017) as well as externalizing problems (P = 0.030). Years of illness were significantly more in those presenting with abnormal anxiety/depression (P = 0.011). Duration of steroid medication was significantly higher among those presenting with abnormal anxiety/depression (P = 0.011) and externalizing problems (P = 0.039). IQ was not associated significantly with disease or steroid treatment variables. CONCLUSIONS Psychosocial factors and outcomes may be important correlates of children's nephrotic syndrome and potential targets of thorough assessment and treatment.