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Abstract: SA-PO397

Disease Activity in Longstanding Glomerular Diseases: The Columbia University-CureGN Experience

Session Information

Category: Glomerular Diseases

  • 1203 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

  • Delbarba, Elisa, Spedali Civili di Brescia, Cologne, Italy
  • Marasa, Maddalena, Columbia University, New York, New York, United States
  • Piva, Stacy E., Columbia University Medical Center, New York, New York, United States
  • Chatterjee, Debanjana, Columbia University, New York, New York, United States
  • Kil, Byum hee, Columbia University, New York, New York, United States
  • Mu, Xueru, Columbia University, New York, New York, United States
  • Gharavi, Ali G., Columbia University, New York, New York, United States
  • Bomback, Andrew S., Columbia University, New York, New York, United States

Group or Team Name

  • On Behalf of the CureGN Consortium
Background

Glomerular diseases are characterized by variable disease activity over many years. The CureGN study enrolls patients (pts) with minimal change disease (MCD), focal segmental glomerulosclerosis (FSGS), membranous nephropathy (MN), and IgA nephropathy (IgAN) whose 1st biopsy falls within 5 years of enrollment. We aimed to determine whether pts with more longstanding disease would show similar disease activity as CureGN pts.

Methods

Using CureGN’s definitions of disease activity, we compared activity in pts followed at Columbia & excluded from CureGN due to their 1st biopsy done prior than 5 years from screening (Out of Window, OW) to both enrolled Columbia pts (CUMC) & to the entire CureGN cohort. For the OW, we assessed disease activity at the 1st clinical encounter from Nov 2014 (when CureGN enrollment opened). For the CureGN pts, we used disease activity at enrollment.

Results

OW and CUMC pts were similar in age, sex, and race; the CureGN cohort had a greater representation of African-Americans compared to the CUMC and OW. OW pts had, on average, lower eGFR than both CUMC and CureGN ones. For each disease subtype, disease activity in the OW cohort was equal or higher than disease activity in both the entire CureGN and the CUMC cohort (Fig1). When limiting our comparisons to disease activity in “incident” CUMC pts (1st diagnostic biopsy within 6 months of enrollment), OW pts demonstrated similar activity rates as incident pts (91% MCD, 60% FSGS, 73% MN, 80% IgA). Disease activity also did not differ by comparison for treatment thresholds.

Conclusion

Disease activity did not differ among pts with shorter vs longer duration of disease. Our OW cohort may include pts with more severe disease variants who still require a careful follow-up >5 years after initial diagnosis. Such pts are potentially highly informative for understanding the clinical course and pathogenesis of glomerulopathies and can help identify risk factors mediating more chronic subtypes of disease.

Funding

  • NIDDK Support