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Abstract: TH-PO472

Incidence of Cardiovascular Events Among Glomerular Disease Participants in the Cure Glomerulonephropathy Network (CureGN)

Session Information

Category: Glomerular Diseases

  • 1303 Glomerular Diseases: Clinical‚ Outcomes‚ and Trials

Authors

  • Wadhwani, Shikha, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
  • Mansfield, Sarah, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
  • Smith, Abigail R., Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
  • Robinson, Bruce M., Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
  • Ashoor, Isa, LCMC Health, New Orleans, Louisiana, United States
  • Chishti, Aftab S., Kentucky Children's Hospital, Lexington, Kentucky, United States
  • Hayek, Salim, University of Michigan, Ann Arbor, Michigan, United States
  • Hladunewich, Michelle A., Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
  • Madapoosi, Siddharth S., University of Michigan, Ann Arbor, Michigan, United States
  • Mariani, Laura H., University of Michigan, Ann Arbor, Michigan, United States
  • Mottl, Amy K., The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
  • O'Shaughnessy, Michelle M., University College Cork, Cork, Cork, Ireland
  • Parsa, Afshin, National Institutes of Health, Bethesda, Maryland, United States
  • Selewski, David T., Medical University of South Carolina, Charleston, South Carolina, United States
  • Wang, Chia- Shi, Emory University School of Medicine, Atlanta, Georgia, United States
  • Weaver, Donald J., Levine Children's Hospital, Charlotte, North Carolina, United States
  • Khalid, Myda, Riley Hospital for Children at Indiana University Health, Indianapolis, Indiana, United States

Group or Team Name

  • CureGN ERO Writing Group
Background

Cardiovascular (CV) events are known extra-renal complications of glomerular disease that cause increased rates of hospitalization, morbidity, and mortality. This analysis describes CV outcomes in CureGN, a prospective cohort study of adults and children with biopsy-proven minimal change disease (MCD), focal segmental glomerulosclerosis (FSGS), membranous nephropathy (MN), or IgA nephropathy/vasculitis (IgA) from 65 US and 6 international sites.

Methods

Multivariable Cox regression was used to estimate associations with first post-enrollment CV event, among those without prior CV events.

Results

The cohort included 2423 participants (566 MCD, 615 FSGS, 546 MN, 696 IgA). At enrollment, median age was 31 yrs (IQR 14-51), with 35% children, 57% male, 13% Hispanic, and 16% Black. At enrollment, median eGFR was 83 ml/min/1.73m2 (IQR 54-103) and median UPCR was 1.2 g/g (IQR 0.2-3.9). Median follow-up was 3.8 years (IQR 2.2-5.1). Overall, 96 participants (22 children, 74 adults) experienced at least one CV event post-enrollment, most commonly arrhythmia followed by heart failure. The cumulative incidence at 1-, 3-, and 5-years post-enrollment was 0.2%, 1.3%, and 1.9%, respectively, for children, and 1.4%, 4.4%, and 7.1%, respectively, for adults. Higher hazard of first CV event post-enrollment was associated with older age (HR=1.1 per 5 yrs), lower eGFR at enrollment (HR=0.88 per 10 mL/min/1.73 m2), and higher UPCR (HR=1.03 per g/g) [Figure]. Glomerular disease subtype was not associated with hazard of CV event (p=0.58).

Conclusion

CV events were associated with older age and kidney disease severity, but not glomerular disease subtype, in this cohort. Further study and longer follow-up will improve understanding of CV risk in patients with glomerular disease and inform practice guidelines.

Sequential time from enrollment to first cardiovascular event Cox models

Funding

  • NIDDK Support