Abstract: TH-PO119

Kidney and Patient Survival in Glomerulonephritis: Results from a Mexican Cohort

Session Information

Category: Glomerular

  • 1004 Clinical/Diagnostic Renal Pathology and Lab Medicine

Authors

  • Martínez, Petra, Hospital of Specialties,CMNO,IMSS, Guadaljara, Jalisco, Mexico
  • Mondragon, Liliana, IMSS, Guadalajara, Mexico
  • Gomez-Navarro, Benjamin, IMSS, HECMNO, Zapopan, Jalisco, Mexico
  • Villanueva-Perez, Arisbeth, Patologia y nefropatologia, Guadalajara, Mexico
  • Cueto-Manzano, Alfonso M., None, Zapopan, Jalisco, Mexico
  • Rojas-Campos, Enrique, INSTITUTO MEXICANO DEL SEGURO SOCIAL, GUADALAJARA, Mexico
Background

Background: There is scarce information of glomerulonephritis (GN) survival in our setting. Objective: To evaluate kidney and patient survival in GN.

Methods

Methods: Retrospective cohort. From kidney biopsy records, all cases with GN diagnosis, ≥16 yrs, and any gender, were included; transplant biopsies excluded. Data were obtained from medical charts. At the end of follow-up, patient status was registered as alive, dead or lost, and kidney status as functioning or failure. Statistical Analysis: Kaplan Meier and Log-rank analysis used to evaluate mortality, and Cox Hazard Proportional Model to evaluate mortality risk factors.

Results

Results: 328 biopsies were analyzed; age 33±13 yrs, 67% female, follow-up 35±11 months. Comparison between primary vs secondary GN is shown in Table. Figure A, show the most common clinical presentation. Type of GN: Lupus nephritis 41%, Focal segmental glomerulosclerosis 23%, Membranous nephropathy 12%, other 24%. Figure B and C, shows patient and kidney survival; 32 (10%) developed ESRD, and 15 (5%) died at follow-up. In multivariate analysis, final systolic blood pressure (SBP, RR 1.29, 95%CI: 1.00-1.06, p=0.04), and age (RR 1.03, 95%CI: 0.99-1.07, p=0.06) predicted death, whereas baseline SBP (RR 1.45, 95%CI: 0.83-250, p=0.01) and baseline creatinine (RR 3.09, 95%IC: 1.03-9.26, p=0.02) predicted kidney survival.

Conclusion

Conclusions: Primary GN had lower SBP and higher cholesterol, CrCl and proteinuria at baseline than Secondary GN; however these differences disappeared at the end of follow-up. Patient and kidney survival were similar to other series, and were not different between Primary and Secondary GN.

VariableGN primary GN Secondary 
 BaselineFinalBaselineFinal
SBP (mmHg)122±15120±16125±16*123±15
DBP (mmHg)77±1076±1077±1077±10
Cholesterol (mg/dL)230 (180-270)213 (154-254)£220 (176-265)*214 (152-247)£
CrCl (ml/min/1.73m2)80 (60-107)82 (55-97)69 (42-92)75 (48-94)*
Proteinuria (g/day)3100 (1100-6500)573(228-1400)£1800 (595-3500)*499 (210-1500)£

*p<0.05 vs same evaluation of primary GN; £p<0.05 vs baseline of the same-group.