Abstract: PO2261
Biopsy-Proven CKD Etiology and Outcomes: The CKD Japan Cohort (CKD-JAC) Study
Session Information
- CKD: Associations and Electrolytes
November 04, 2021 | Location: On-Demand, Virtual Only
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2101 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention
Authors
- Hamano, Takayuki, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
- Imaizumi, Takahiro, Nagoya University, Nagoya, Aichi, Japan
- Hasegawa, Takeshi, Showa University Research Administration Center, Tokyo, Japan
- Fujii, Naohiko, Hyogo Prefectural Nishinomiya Hospital, Nishinomiya, Hyogo, Japan
- Komaba, Hirotaka, Tokai University, Isehara, Japan
- Fukagawa, Masafumi, Tokai University, Isehara, Japan
Background
The KDIGO guidelines advocated cause-GFR-albuminuria (CGA) classification for predicting outcomes. However, a dearth of data exists supporting the use of the cause of chronic kidney disease (CKD). This study aimed to address how to incorporate prior biopsy-proven diagnosis in predicting outcomes.
Methods
We compared end-stage kidney disease (ESKD) and all-cause death before ESKD among various biopsy-proven diagnoses (n = 778) in Analysis A. In Analysis B, the same outcomes were compared among biopsy-proven diabetic nephropathy (DN), biopsy-proven other diseases, and no biopsy in those with a history of diabetes mellitus (n = 1117).
Results
In analysis A, adding biopsy-proven diagnoses to GFR-albuminuria (GA) classification significantly improved both net reclassification improvement and integrated discrimination improvement to predict the 8-year incidence of ESKD and all-cause death. Fine-Gray (FG) models with ESKD as a competing event showed significantly higher subdistribution hazard ratios (sHRs) for all-cause death in nephrosclerosis (4.12 [1.11–15.2]), focal segmental glomerulosclerosis (3.77 [1.09–13.1]), and membranous nephropathy (MN) (2.91 [1.02–8.30]) as compared to IgA nephropathy, while Cox model failed to show significant associations. Crescentic glomerulonephritis had the highest risk of all-cause death (sHR 5.90 [2.05–17.0]). MN had a significantly lower risk of ESKD than IgA nephropathy (sHR 0.45, [95% Confidence interval:0.24–0.84]). In analysis B, biopsy-proven other diseases had a lower risk of ESKD as compared to biopsy-proven DN in FG model with death as a competing event (sHR 0.62 [0.39–0.97]).
Conclusion
The Biopsy-proven cause of CKD is of great value in predicting outcomes in CKD adjusting for GA classification.
Funding
- Commercial Support –