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Abstract: PO1882

Estimation of Childhood Nephrotic Syndrome Incidence: Data from the Atlanta Metropolitan Statistical Area and Meta-Analysis of Worldwide Cases

Session Information

Category: Glomerular Diseases

  • 1203 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

  • Londeree, Jackson, Emory University School of Medicine, Atlanta, Georgia, United States
  • Greenbaum, Larry A., Emory University School of Medicine, Atlanta, Georgia, United States
  • Anderson, Evan, Emory University School of Medicine, Atlanta, Georgia, United States
  • Plantinga, Laura, Emory University School of Medicine, Atlanta, Georgia, United States
  • Mccracken, Courtney, Emory University School of Medicine, Atlanta, Georgia, United States
  • Gillespie, Scott, Emory University School of Medicine, Atlanta, Georgia, United States
  • Wang, Chia- Shi, Emory University School of Medicine, Atlanta, Georgia, United States
Background

There is limited epidemiological data on childhood idiopathic nephrotic syndrome (NS) in the United States. We estimated contemporary childhood NS incidence estimates in a racially and ethnically diverse U.S. population, and performed a meta-analysis of published reports to examine differences by race and ethnicity and changes over time.

Methods

Children 1-17 years-old diagnosed with NS in the Atlanta MSA between 1/1/2013 and 12/31/2018 were identified by chart review using practice data from the only pediatric nephrology practice in the region. Annual incidence rates were calculated by dividing the number of cases by population data provided by the Georgia Department of Public Health. We also performed a literature review for published childhood NS incidence and calculated pooled incidence estimates using random-effects regression models. Incidence estimates by race and ethnicity were compared by computing pooled estimates within each subgroup and testing for significant heterogeneity between subgroup estimates. We also reviewed U.S. incidence over time comparing pooled incidence estimates before and after 1984.

Results

175 children aged 1-17y were diagnosed with NS between 2013-2018 in the Atlanta MSA. Incidence by race and ethnicity from the Atlanta MSA and meta-analysis demonstrated highest incidence in Asian children, followed by those of African descent, Hispanics and Caucasians (Table 1). Incidence in the U.S. was stable over time.

Conclusion

Risk for childhood NS development differs by race and ethnicity without changes over time. Future studies need to evaluate the underlying genetic and environmental factors associated with NS incidence.

Table 1. Incidence of childhood idiopathic nephrotic syndrome
SubgroupAtlanta MSA, 2013 – 2018
(mean, 95% Confidence Interval)
Incidence Rate Ratio (p value)Worldwide Meta-analysis
(median, 95% Confidence Interval)
Q (p value)a
Overall2.13 (1.83-2.47)-2.26 (1.99-2.54)-
Caucasian1.60 (1.24-2.02)Reference1.83 (1.52-2.14)Reference
African Descent2.47 (1.94-3.10)1.55 (0.01)3.53 (2.93 -4.12)24.57 (<0.001)
Asian5.04 (3.20-7.57)3.15 (<0.001)7.14 (4.73-9.5418.37 (<0.001)
Hispanic b2.13 (1.40-3.10)0.998 (>0.99)--
 US incidence (median, 95% Confidence Interval)Q (p value)a
Prior to 19852.05 (1.85-2.25)Reference
After 19852.26 (2.14-2.37)Q= 3.02 (0.082)

aTest of heterogeneity bCompared to non-Hispanics