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A longitudinal study on the effects of psychological stress on proteinuria in childhood steroid-sensitive nephrotic syndrome

OBJECTIVE: Steroid-sensitive nephrotic syndrome (SSNS) in children is often complicated by one or more relapses, as manifested by the appearance of proteinuria. Besides health-related triggers, psychological stress might be related to relapse. This longitudinal study examined the link between percei...

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Autores principales: Bakkum, Lianne, Willemen, Agnes Maresa, Zoetebier, Lydia, Bouts, Antonia H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Pergamon Press 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6543065/
https://www.ncbi.nlm.nih.gov/pubmed/30739735
http://dx.doi.org/10.1016/j.jpsychores.2019.01.011
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author Bakkum, Lianne
Willemen, Agnes Maresa
Zoetebier, Lydia
Bouts, Antonia H.
author_facet Bakkum, Lianne
Willemen, Agnes Maresa
Zoetebier, Lydia
Bouts, Antonia H.
author_sort Bakkum, Lianne
collection PubMed
description OBJECTIVE: Steroid-sensitive nephrotic syndrome (SSNS) in children is often complicated by one or more relapses, as manifested by the appearance of proteinuria. Besides health-related triggers, psychological stress might be related to relapse. This longitudinal study examined the link between perceived stress, emotional valence (feeling happy vs. unhappy) and daily reported proteinuria, and investigated the temporal relation between stressful events and proteinuria. METHOD: Sixteen children (4–13 years) diagnosed with SSNS were included. Patients kept an online diary for an average of 124 days, wherein they reported proteinuria (n = 1985 urine samples), perceived stress, emotional valence, medication use and health complaints. Stressful days were determined at the start of the study. Using multilevel analysis, the following associations were tested: (1) the relation between perceived stress, emotional valence and proteinuria, and (2) the temporal relation between stressful days and proteinuria. RESULTS: Appearance of proteinuria was reported in 410/1985 urine samples. Perceived stress and not emotional valence significantly predicted proteinuria (95% CI [0.11, 0.27]), even five days later. There was a significant temporal association between stressful days and proteinuria (95% CI [0.22, 1.14]). The effect sizes of these associations were small, f = 0.04 and f = 0.12, respectively. CONCLUSIONS: Our findings suggest that psychological stress may trigger proteinuria in children with SSNS. Future research in larger samples is needed to support our findings.
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spelling pubmed-65430652019-06-04 A longitudinal study on the effects of psychological stress on proteinuria in childhood steroid-sensitive nephrotic syndrome Bakkum, Lianne Willemen, Agnes Maresa Zoetebier, Lydia Bouts, Antonia H. J Psychosom Res Article OBJECTIVE: Steroid-sensitive nephrotic syndrome (SSNS) in children is often complicated by one or more relapses, as manifested by the appearance of proteinuria. Besides health-related triggers, psychological stress might be related to relapse. This longitudinal study examined the link between perceived stress, emotional valence (feeling happy vs. unhappy) and daily reported proteinuria, and investigated the temporal relation between stressful events and proteinuria. METHOD: Sixteen children (4–13 years) diagnosed with SSNS were included. Patients kept an online diary for an average of 124 days, wherein they reported proteinuria (n = 1985 urine samples), perceived stress, emotional valence, medication use and health complaints. Stressful days were determined at the start of the study. Using multilevel analysis, the following associations were tested: (1) the relation between perceived stress, emotional valence and proteinuria, and (2) the temporal relation between stressful days and proteinuria. RESULTS: Appearance of proteinuria was reported in 410/1985 urine samples. Perceived stress and not emotional valence significantly predicted proteinuria (95% CI [0.11, 0.27]), even five days later. There was a significant temporal association between stressful days and proteinuria (95% CI [0.22, 1.14]). The effect sizes of these associations were small, f = 0.04 and f = 0.12, respectively. CONCLUSIONS: Our findings suggest that psychological stress may trigger proteinuria in children with SSNS. Future research in larger samples is needed to support our findings. Pergamon Press 2019-06 /pmc/articles/PMC6543065/ /pubmed/30739735 http://dx.doi.org/10.1016/j.jpsychores.2019.01.011 Text en © 2019 The Authors http://creativecommons.org/licenses/by/4.0/ This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Bakkum, Lianne
Willemen, Agnes Maresa
Zoetebier, Lydia
Bouts, Antonia H.
A longitudinal study on the effects of psychological stress on proteinuria in childhood steroid-sensitive nephrotic syndrome
title A longitudinal study on the effects of psychological stress on proteinuria in childhood steroid-sensitive nephrotic syndrome
title_full A longitudinal study on the effects of psychological stress on proteinuria in childhood steroid-sensitive nephrotic syndrome
title_fullStr A longitudinal study on the effects of psychological stress on proteinuria in childhood steroid-sensitive nephrotic syndrome
title_full_unstemmed A longitudinal study on the effects of psychological stress on proteinuria in childhood steroid-sensitive nephrotic syndrome
title_short A longitudinal study on the effects of psychological stress on proteinuria in childhood steroid-sensitive nephrotic syndrome
title_sort longitudinal study on the effects of psychological stress on proteinuria in childhood steroid-sensitive nephrotic syndrome
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6543065/
https://www.ncbi.nlm.nih.gov/pubmed/30739735
http://dx.doi.org/10.1016/j.jpsychores.2019.01.011
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