Supplementary Material for: Racial-Ethnic Differences in Health-Related Quality of Life among Adults and Children with Glomerular Disease

Introduction: Disparities in health-related quality of life (HRQOL) have been inadequately studied in patients with glomerular disease. The aim of this study was to identify relationships among race/ethnicity, socioeconomic status, disease severity, and HRQOL in an ethnically and racially diverse cohort of patients with glomerular disease. Methods: Cure Glomerulonephropathy (CureGN) is a multinational cohort study of patients with biopsy-proven glomerular disease. Associations between race/ethnicity and HRQOL were determined by the following: (1) missed school or work due to kidney disease and (2) responses to Patient-Reported Outcomes Measurement Information System (PROMIS) questionnaires. We adjusted for demographics, socioeconomic status, and disease characteristics using multivariable logistic and linear regression. Results: Black and Hispanic participants had worse socioeconomic status and more severe glomerular disease than white or Asian participants. Black adults missed work or school most frequently due to kidney disease (30 vs. 16–23% in the other 3 groups, p = 0.04), and had the worst self-reported global physical health (median score 44.1 vs. 48.0–48.2, p < 0.001) and fatigue (53.8 vs. 48.5–51.1, p = 0.002), compared to other racial/ethnic groups. However, these findings were not statistically significant with adjustment for socioeconomic status and disease severity, both of which were strongly associated with HRQOL in adults. Among children, disease severity but not race/ethnicity or socioeconomic status was associated with HRQOL. Conclusions: Among patients with glomerular disease enrolled in CureGN, the worse HRQOL reported by black adults was attributable to lower socioeconomic status and more severe glomerular disease. No racial/ethnic differences in HRQOL were observed in children.

引言：健康相关生活质量（Health-Related Quality of Life, HRQOL）的差异在肾小球疾病患者中尚未得到充分研究。本研究旨在在种族与民族多元化的肾小球疾病患者队列中，明确种族/民族、社会经济地位、疾病严重程度与健康相关生活质量之间的关联。方法：治愈肾小球病（Cure Glomerulonephropathy, CureGN）是一项针对经活检证实的肾小球疾病患者的多国队列研究。本研究通过以下两项指标评估种族/民族与健康相关生活质量的关联：(1) 因肾脏疾病缺课或误工情况；(2) 患者报告结局测量信息系统（Patient-Reported Outcomes Measurement Information System, PROMIS）问卷的应答结果。本研究采用多变量logistic回归与线性回归模型，对人口学特征、社会经济地位及疾病特征进行了校正。结果：与白人或亚洲参与者相比，黑人和西班牙裔参与者的社会经济地位更低，肾小球疾病病情更严重。与其他种族/民族群体相比，黑人成年人因肾脏疾病缺课或误工的比例最高（30%，其余三组为16%~23%，p=0.04），且自我报告的总体身体健康状况（中位数得分44.1，其余三组为48.0~48.2，p<0.001）与疲劳程度（中位数得分53.8，其余三组为48.5~51.1，p=0.002）均最差。然而，在校正社会经济地位与疾病严重程度后，上述差异不再具有统计学显著性；而这两项因素均与成年人的健康相关生活质量密切相关。在儿童患者中，仅疾病严重程度与健康相关生活质量相关，而与种族/民族及社会经济地位无关。结论：在参与CureGN研究的肾小球疾病患者中，黑人成年人报告的更差健康相关生活质量可归因于较低的社会经济地位与更严重的肾小球疾病。儿童患者的健康相关生活质量未观察到种族/民族差异。