Kidney Week

Abstract: TH-PO1046

Differences in Disease Activity by Sex and Pubertal/Menopausal Status in Primary Glomerulonephropathies

Session Information

• Glomerular Diseases: Epidemiology, Mechanisms, Complications, Outcomes
  November 07, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Glomerular Diseases

• 1203 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

• Oliverio, Andrea L., University of Michigan, Ann Arbor, Michigan, United States

Andrea L. Oliverio,



• Mansfield, Sarah, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States

Sarah Mansfield,



• Almaani, Salem, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States

Salem Almaani,



• Ayoub, Isabelle, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States

Isabelle Ayoub,



• Clark, Kira, Oregon Health and Science University, Portland, Oregon, United States

Kira Clark,



• Fernandez, Hilda E., NYP-CUMC, New York, New York, United States

Hilda E. Fernandez,



• Khairallah, Pascale, Columbia University Medical Center, New York, New York, United States

Pascale Khairallah,



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

Michelle M. O'Shaughnessy,



• Reynolds, Monica Lona, University of North Carolina at Chapel Hill, Cary, North Carolina, United States

Monica Lona Reynolds,



• Twombley, Katherine, Medical University of South Carolina, Charleston, South Carolina, United States

Katherine Twombley,



• Wadhwani, Shikha, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States

Shikha Wadhwani,



• Vasylyeva, Tetyana L., Texas Tech University Health Sciences Center, Lubbock, Texas, United States

Tetyana L. Vasylyeva,



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

Jarcy Zee,



• Hladunewich, Michelle A., University of Toronto, Toronto, Ontario, Canada

Michelle A. Hladunewich,



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

Laura H. Mariani,

Background

CKD has been observed to progress more slowly in women than men. However, large studies examining associations between sex, reproductive stage, and disease activity and progression in primary glomerulonephropathies are lacking.

Methods

CureGN is a 70-site prospective cohort study of patients with MCD, FSGS, IgAN/IgAV, or MN. Patients with available eGFR, UPCR, and reproductive stage at enrollment were studied. Reproductive stage was categorized as pre-pubertal (Tanner stage I-III), post-pubertal (Tanner stage IV-V, or menarche for females), or post-menopausal (females only). Multivariable mixed linear models adjusted for baseline data at time of enrollment (Table) were fit to examine change in eGFR and UPCR over time.

Results

Median follow-up from enrollment was 2.1 (IQR 1.0-3.1) yrs. Among 1202 patients with available enrollment eGFR, adjusted (Model 3) eGFR slopes amongst females were +0.71, -0.84, and -1.43 ml/min/1.73m2 per year for pre-pubertal, post-pubertal, and post-menopausal women, respectively (Table). For pre-pubertal and post-pubertal males, eGFR slopes were -1.14 and -1.19 ml/min/1.73m2 per year, respectively. Adjusted UPCR slopes by sex and reproductive stage are also shown in the Table.

Conclusion

The protective effect of female sex on eGFR decline was most notable prior to puberty. Of all groups, post-menopausal women had the fastest eGFR decline. Unlike post-pubertal males and females, pre-pubertal participants experienced no significant decrease in UPCR over time, and menopausal status did not seem to impact the rate of UPCR decline seen in post-pubertal females.

Funding

• NIDDK Support