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Kidney Week

Abstract: PO1880

Clinical Characteristics, Treatment Patterns, and Outcomes of Children and Adults with Biopsy-Proven Minimal Change Disease from the Cure Glomerulonephropathy Network Study (CureGN)

Session Information

Category: Glomerular Diseases

  • 1203 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

  • Chen, Dhruti P., University of North Carolina, Chapel Hill, North Carolina, United States
  • Helmuth, Margaret, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
  • Gbadegesin, Rasheed A., Duke University Hospital, Durham, North Carolina, United States
  • Mottl, Amy K., University of North Carolina, Chapel Hill, North Carolina, United States
  • Gipson, Debbie S., University of Michigan Mott Children's Hospital, Ann Arbor, Michigan, United States
  • Twombley, Katherine, Medical University of South Carolina, Charleston, South Carolina, United States

Group or Team Name

  • The Cure Glomerulonephropathy Network Study (CureGN)
Background

The age of Minimal Change Disease (MCD) onset spans all ages. We analyzed the CureGN multi-center observational cohort study to elucidate differences in natural history and treatment patterns by age of MCD onset.

Methods

567 participants enrolled within 5 years from kidney biopsy were available. Continuous variables are described as median [25,75 percentile] or n[%]. Univariate comparisons were performed using chi-square tests and Wilcoxon rank-sum tests for categorical and continuous variables, respectively. eGFR was winsorized to 120 ml/min in repeated measures models used to assess eGFR over time.

Results

Comparisons by age group are shown in the Table. There were modest differences in the racial/ethnic composition and weight. Severity of proteinuria was similar at disease onset [6.1 vs 6.5, p-value=0.5] but higher in adults at biopsy (6.6 vs. 3.4, p-value=<0.001). At biopsy, eGFR was higher in children than adults (127.7 vs 88.6, p-value<0.001), and were more likely to have received immunosuppression prior to biopsy (58% vs. 18%, p-value<0.001). Compared to children, adults were more likely to report a history of HTN (29% vs 43%, p-value<0.001). Children were more likely to have frequently relapsing/steroid dependent disease than adults (51% vs. 29%, p-value <0.0001) and higher steroid resistant disease than adults (17% vs. 12%, p-value <0.0001). Over a median of 29.1 months follow up, ESKD occurred in 13 (2%) participants (8 children; 5 adults) and deaths occurred in 3 (1%) (1 child, 2 adult).

Conclusion

Significant sociodemographic and clinical differences exist between adult-onset versus pediatric onset MCD at the time of biopsy. These differences are most likely due to differences in treatment and biopsy practices relative to symptom onset.

Funding

  • NIDDK Support