Kidney Week

Abstract: SA-PO400

Infectious Complications in Patients with Glomerular Disease: An Analysis of the Cure Glomerulonephropathy (CureGN) Study

Session Information

• Glomerular Diseases: Clinical, Outcomes, Trials - III
  October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Glomerular Diseases

• 1203 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

• Glenn, Dorey A., University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States

Dorey A. Glenn,

• Henderson, Candace Dione, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States

Candace Dione Henderson,

• Hu, Yichun, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States

Yichun Hu,

• Zinsser, Dawn, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States

Dawn Zinsser,

• O'Shaughnessy, Michelle M., Stanford University, Palo Alto, California, United States

Michelle M. O'Shaughnessy,

• Greenbaum, Larry A., Emory University, Atlanta, Georgia, United States

Larry A. Greenbaum,

• Zee, Jarcy, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States

Jarcy Zee,

• Bomback, Andrew S., Columbia University, New York, New York, United States

Andrew S. Bomback,

• Gibson, Keisha L., University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States

Keisha L. Gibson,

• Mottl, Amy K., University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States

Amy K. Mottl,

• Hogan, Susan L., University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States

Susan L. Hogan,

• Nachman, Patrick H., University of Minnesota, Minneapolis, Minnesota, United States

Patrick H. Nachman,

• Falk, Ronald J., University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States

Ronald J. Falk,

Group or Team Name

• CureGN Consortium

Background

Infections are an important contributor to patient morbidity and mortality in glomerular disease (GD). We sought to understand the epidemiology of infections and infection-related healthcare utilization among patients with GD.

Methods

CureGN is a prospective multi-center cohort study of patients with minimal change disease (MCD), focal segmental glomerulosclerosis (FSGS), membranous nephropathy (MN), or IgA Nephropathy/Vasculitis (IgAN/IgAV). We describe the rate of infections requiring hospitalization or emergency department (ED) visit, primary infection sites, hospital lengths of stay, and ICU use within this cohort, stratified by age and GD type.

Results

Overall, 202 confirmed infections occurred in 158 (8%) of 1965 participants over a mean follow up time of 1.3 years (SD 0.9), a rate of 0.08 infections per person year. Ten percent of all hospitalizations or ED visits were due to infection. The rate of infection-related hospitalizations or ED visits was significantly higher in children (p<0.001), and in patients with MCD relative to MN (p=0.02) or IgAN/IgAV (p=0.004). Admission to the ICU was required in 9% of infection-related hospitalizations. The most frequent sites of infection were the lower (23%) and upper (23%) respiratory tract, and gastrointestinal system (13%).

Conclusion

Infection-related ED visits and hospitalizations are an important contributor to healthcare utilization among patients with GD. Further study is needed to analyze risk factors for infection and develop strategies to mitigate these events. Attention should focus on children and those with MCD, who have the highest rates of infection-related healthcare utilization.

Funding

• NIDDK Support