ESPN 53rd Annual Meeting

ESPN 2021


 
Association Between Deprivation and Worse Outcomes in Nephrotic Syndrome
ABIGAIL TOWNSEND 1 THOMAS DOWSETT 2 LOUISE ONI 2 CAROLINE JONES 2

1- UNIVERSITY OF LIVERPOOL
2- DEPARTMENT OF PAEDIATRIC NEPHROLOGY, ALDER HEY CHILDRENS HOSPITAL, NHS TRUST, LIVERPOOL, UK
 
Abstract:

Objectives This study explores whether higher levels of deprivation could influence rates of relapse and treatment in childhood nephrotic syndrome (NS), and if additional support from social services could improve outcomes in these patients. 

Methods A retrospective cohort study of 27 patients with childhood NS treated at Alder Hey Children’s Hospital was conducted. Inclusion criteria included a Liverpool postcode, steroid responsive NS, and age 1-18 years. Records were searched over a 24-month period and data collected on number of relapses, hospital admissions, Did Not Attend (DNA) appointments, courses of rituximab and second line immunosuppressive agents. Patients were grouped into deciles according to their postcode using the Index of Multiple Deprivation (IMD) 2019. Univariant analysis and the Mann-Whitney U test were used to assess the associations between the IMD decile and outcomes. 

 

Results 19 (70%) of 27 of patients resided in the top 20% most deprived areas. 13 (93%) of 14 admissions occurred in these patients, which was statistically significant (0.68 vs 0.13, p=0.048). 47 (81%) of 58 relapses also occurred in these patients. 9 (90%) of 10 rituximab courses and 18 (95%) of 19 DNA appointments occurred in patients living in the top 10% most deprived areas. There was no statistically significant association for number of relapses or use of second line immunosuppressants. 

 

Conclusions Social deprivation was associated with increased number of hospital admissions in childhood NS in a small cohort of patients residing in Liverpool, one of the most deprived regions in the United Kingdom. More research is needed to understand how deprivation may influence outcomes and therefore management of childhood NS.