Kidney Week

Abstract: FR-OR090

Risk Factors for Infection in Patients with Glomerular Disease: An Analysis of the Cure Glomerulonephropathy (CureGN) Study

Session Information

• Lupus and Then Some
  November 08, 2019 | Location: Ballroom C, Walter E. Washington Convention Center
  Abstract Time: 06:18 PM - 06:30 PM

Category: Glomerular Diseases

• 1203 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

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

Dorey A. Glenn, MD, MPH



Dr. Glenn is an assistant professor of medicine and pediatrics at the University of North Carolina. He researches the epidemiology of adverse outcomes in patients with glomerular disease. His current work includes assessing rates of skeletal fracture in UNC’s Glomerular Disease Collaborative Network cohort and analyzing infectious complications in a national cohort of patients with glomerular disease. He is also involved in the clinical care of children with renal disease at the University of North Carolina.

• Henderson, Candace Dione, UNC Kidney Center, Chapel Hill, North Carolina, United States

Candace Dione Henderson,

• Hu, Yichun, UNC Kidney Center & Divisions of Nephrology & Hypertension, Chapel Hill, North Carolina, United States

Yichun Hu,

• 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,

• Mariani, Laura H., University of Michigan, Ann Arbor, Michigan, United States

Laura H. Mariani,

• Gibson, Keisha L., UNC Kidney Center, Chapel Hill, North Carolina, United States

Keisha L. Gibson,

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

Susan L. Hogan,

• Falk, Ronald J., UNC Kidney Center, Chapel Hill, North Carolina, United States

Ronald J. Falk,

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

Amy K. Mottl,

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 risk factors for infection among patients in the Cure Glomerulonephropathy (CureGN) study.

Methods

CureGN is a prospective multi-center cohort study of patients with biopsy-proven minimal change disease (MCD), focal segmental glomerulosclerosis (FSGS), membranous nephropathy (MN), or IgA nephropathy/vasculitis (IgAN/IgAV). Risk factors for time to first infection-related hospitalization or ED visit were identified using Cox proportional hazards regression. Cox models were adjusted for patient characteristics at enrollment, including demographics [age, race, sex], immunosuppression exposure, GD subtype, number of comorbid conditions, smoking status, time from initial biopsy, and laboratory measurements [eGFR, urine protein to creatinine ratio (UPC), and serum albumin].

Results

Of 1917 participants (43% female, 42% less than 20 years, 67% white), 165 subjects (9%) experienced a first infection over a median follow-up of 15.5 (IQR 7.5 – 24.9) months. In adjusted multivariate models, age < 10 or 20-59 (versus >60) years, black race, and a higher number of comorbidities were significantly (p<0.05) associated with an increased hazard for infection (Table). An association with corticosteroid exposure was of borderline significance (p=0.06).

Conclusion

Among CureGN participants, younger age, black race, and more comorbidities were independently associated with time to first infection-related hospitalization or ED visit. These findings might inform the development of strategies aimed at preventing infection in patients with GD.

Funding

• NIDDK Support