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Abstract: TH-PO1037

Positive Family History for CKD in Patients with Primary Glomerular Diseases: Disease Onset and Comorbidities in the CureGN Cohort

Session Information

Category: Glomerular Diseases

  • 1203 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

  • Carlassara, Lucrezia, Universita' degli Studi di Brescia, Vicenza, Italy
  • Marasa, Maddalena, Columbia University, New York, New York, United States
  • Gbadegesin, Rasheed A., Duke University Medical Center, Durham, North Carolina, United States
  • Gipson, Debbie S., University of Michigan Mott Children's Hospital, Ann Arbor, Michigan, United States
  • Sampson, Matt G., University of Michigan, Ann Arbor, Michigan, United States
  • Julian, Bruce A., University of Alabama at Birmingham, Birmingham, Alabama, United States
  • Sanna-Cherchi, Simone, Columbia University, New York, New York, United States
  • Kiryluk, Krzysztof, Columbia University, New York, New York, United States
  • Bomback, Andrew S., Columbia University, New York, New York, United States
  • Gharavi, Ali G., Columbia University, New York, New York, United States
Background

A positive family history (pFHx) has been associated with worse outcomes for some glomerulonephritides (GNs), but this has not been rigorously examined in a prospective cohort. A pFHx for chronic kidney disease (CKD) can be indicative of Mendelian hereditary diseases, or may reflect a polygenic risk or unmeasured environmental risk factors.

Methods

We studied the association of a self-reported pFHx of CKD with renal function, age at the time of diagnosis and comorbidity burden, in the Cure Glomerulopathy Network (CureGN), a prospective multi-center observational study of GN patients (N=2281) with Focal Segmental Glomerulosclerosis (FSGS), Minimal Change Disease (MCD), Membranous Nephropathy (MN), IgA Nephropathy (IgAN), or IgA Vasculitis (IgAV). Comparisons between patients with and without pFHx were analyzed via Chi-square/Fisher and ANOVA/Wilcoxon test.

Results

A CKD pFHx was present in 352 (15%) patients: 28% of FSGS, 21% of MN, 15% of IgAN, 13% of MCD, and 9% of IgAV cases. CKD pFHx was associated with lower eGFR at GNs onset in entire cohort (p=1.0x10-11), IgAV (p= 0.0002), FSGS (p= 0.0004), IgAN (p= 0.001), and MN (p=0.02) but not MCD patients. CKD pFHx was associated with older age at the GNs onset with adults IgAN (p= 0.006) patients. CKD pFHx was significantly associated with a higher prevalence of several comorbidities, even after adjusting for age, sex, ethnicity, race, body mass index, and smoking habit (Table 1).

Conclusion

Patients with a CKD pFHx have lower eGFR at presentation and have higher prevalence of certain comorbidities than patients without such family history. The association with allergies, asthma and COPD point to shared biology and environmental factors. Identifying this association may help to elucidate common genetic or environmental causes, shed light on disease pathogenesis, improve GNs management, and ultimately may help develop preventive measures.

Funding

  • NIDDK Support