Security in adults with primary nephrotic syndrome

Objective: To analyze the factors affecting psychological security in patients suffering from primary nephrotic syndrome (PNS), and to evaluate the effect of security-insecurity on the conditions and treatment of PNS in adults. Methods: A total of 286 adults with PNS who were first diagnosed as having PNS and met the inclusion criteria were enrolled in our study. The patient's security status was assessed by integrating the patients' self-assessment and the clinicians' judgement. The patients were followed for 6 months. Data were collected from the patients, including demographics, length of hospital stay, 24 h urinary protein at admission and discharge, serum albumin at admission and discharge and clinical outcomes at follow-up. The factors that affect psychological security and clinical outcome of the patients were assessed with the use of univariate regression analysis and logistic regression analysis. Results: The number of male patients with first-diagnosed PNS was larger than that of females, and 39.51% of the patients aged 51-65 years. The association of PNS with the three factors including a family history of kidney disease, relatives died of kidney disease and frequent solitude was not statistically significant (P > 0.05). The rates of normal security, insecurity, lack of security, and severe lack of security occurred in adults with PNS were 9.09%, 34.27%, 33.57% and 23.07%, respectively. No gender difference was shown in the sense of security of patients with PNS. Significant differences in self-security-insecurity and security-insecurity overall score were found between the PNS adults with more income (> 100,000 yuan) and those with less income (< 100,000 yuan) (self-security-insecurity, P=0.039; security-insecurity overall score, P=0.045). Furthermore, lower personal or household income contributed to higher security-insecurity score and a stronger trend of insecurity (P=0.001). Statistically significant differences were observed in the variables including albumin (P=0.018), 24 h urinary protein (P=0.035), length of hospital stay (P=0.022), and prognostic response (P=0.019) before and after treatment among all patients. Logistic regression analysis documented that the outcomes of patients with PNS were positively correlated with personal and household income, Alb level, whereas the psychological security score, 24 h urinary protein and length of hospital stay were the risk factors of clinical outcomes. Conclusion: Income has a great impact on the security of adults suffering from PNS, and a higher psychological security score is a major risk factor for clinical outcome in patients with PNS.