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
- Glomerular Diseases: Clinical, Outcomes, and Trials - 2
October 22, 2020 | Location: On-Demand
Abstract Time: 10:00 AM - 12:00 PM
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