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Abstract: SA-PO395

A Review of Therapies over 17 Years for Glomerular Disease in a Single Center

Session Information

Category: Glomerular Diseases

  • 1203 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

  • Syeda, Sara, Brown University, Cranston, Rhode Island, United States
  • Sharif, Sairah, Brown University, Cranston, Rhode Island, United States
Background

Glomerular disease is the third leading cause of end stage renal disease in adults in the United States. There is lack of consensus on treating glomerular disease due to general lack of randomized control trials in this field. There is a lot of variability in therapy both due to physician and patient factors.

Methods

We undertook this study to evaluate the trends in therapies of the most common glomerular diagnosis over the years in our center. This is a retrospective chart review of medical therapies of 322 patients who underwent a kidney biopsy between year august 2000 to october 2017. We also reviewed pregnancy outcomes of patients who were diagnosed with glomerular disease. Patients who did not have a renal biopsy at our center were excluded.

Results

Results: Our study population is ethnically diverse with 68% white, 16% black, 3% asian and 2% hispanic patients. The 3 most common clinical presentation that lead to renal biopsy were acute kidney injury, nephrotic syndrome and a combination of both. Amongst nephrotic syndrome FSGS was treated with steroids 80%, cyclosporine 20%, tacrolimus 14%, MCD was treated with steroids 99%, and membranous nephropathy was treated with steroids 90%, cyclophosphamide 30% of the cases. Patients with IgANP got renin angiotensin inhibitors 72%, steroids 22% of the time. Patients with ANCA vasculitis got steroids 95% of the time, cyclophosphamide 64% and rituximab 30% of the time. The therapy changed over time and rituximab use was more after 2012. Out of females between ages 18 to 50 years, 20 got pregnant any time after renal biopsy. Out of these pregnancies the live birth was 30%. The most common immunosuppressive drug to be used during pregnancy was mycophenolate and most common anti-hypertensive methyldopa. Pregnancy induced hypertension and preeclampsia was frequent 72%.

Conclusion

In our ethnically diverse population we found that LN, FSGS, MGN and IgANP were the most common glomerular disease. We found a great variability in treatment of glomerular disease including more rituximab after 2012.