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Abstract: TH-PO1019

Factors Associated with ESRD in an IgA Nephropathy Cohort

Session Information

Category: Glomerular Diseases

  • 1203 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

  • Shaffi, Saeed Kamran, University of New Mexico, Albuquerque, New Mexico, United States
  • Gul, Ambreen, Dialysis Clinic Inc, Albuquerque, New Mexico, United States
  • Argyropoulos, Christos, University of New Mexico, Albuquerque, New Mexico, United States
  • Unruh, Mark L., University of New Mexico, Albuquerque, New Mexico, United States
Background

In IgA nephropathy patients, >1 g/day of proteinuria, presence of mesangial hypercellularity, segmental glomerulosclerosis, interstitial fibrosis and tubular atrophy (IFTA) and crescents on kidney biopsy are associated with progression to ESRD. We describe the factors associated with ESRD in an IgA nephropathy cohort with a substantial number of Native Americans and Hispanics.

Methods

We created a cohort of biopsy-proven IgA nephropathy from the UNM kidney biopsy registry which includes biopsies performed between 2002-2016. The demographic and clinical data were abstracted from the electronic medical record. The incidence of ESRD was obtained by chart review until 2016. We used age and sex adjusted Cox proportional hazards models to study the association of the predictor variables (mesangial and endocapillary hypercellularity, segmental glomerulosclerosis, IFTA, crescents, and proteinuria) with the incidence of ESRD. Patients were censored upon death or the last follow-up date for the ESRD outcome. We reported hazard ratios for ESRD with 95% confidence intervals (CI).

Results

Of the 66 patients identified with IgA nephropathy, there were 40.9% females, 36.4% Caucasians, 22.7% Hispanics, and 21.2% Native Americans. Mean biopsy age was 35.2 years (SD 16.9). Median creatinine (Cr) and CKD-EPI Cr equation eGFR were 3.1 mg/dl (IQR 2.8), and 23.2 ml/min/1.73m2 (IQR 27), respectively. Mean proteinuria was 1.9 g/g (SD 2.7). A total of 45% of patients developed ESRD with a mean follow-up of 4 years. Patients with IFTA involving >50% of the cortical area and those with >50% glomeruli exhibiting global glomerulosclerosis were 4.86 and 2.86 times more likely to develop ESRD than the comparison group, respectively. (Fig 1)

Conclusion

This study demonstrates that significant glomerulosclerosis and IFTA are associated with the development of ESRD in an IgA nephropathy cohort comprising of many Native Americans and Hispanics.

Funding

  • Private Foundation Support