Kidney Week

Abstract: FR-PO662

Predictors of Progression to Kidney Failure in Patients With Focal Segmental Glomerulosclerosis

Session Information

• Glomerular Diseases: Clinical, Outcomes, Trials - II
  November 04, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
  Abstract Time: 10:00 AM - 12:00 PM

Category: Glomerular Diseases

• 1303 Glomerular Diseases: Clinical‚ Outcomes‚ and Trials

Authors

• Tuttle, Katherine R., Providence St Joseph Health, Spokane, Washington, United States

Katherine R. Tuttle,

• Daratha, Kenn B., Providence St Joseph Health, Spokane, Washington, United States

Kenn B. Daratha,

• Jones, Cami R., Providence St Joseph Health, Spokane, Washington, United States

Cami R. Jones,

• Kornowske, Lindsey M., Providence St Joseph Health, Spokane, Washington, United States

Lindsey M. Kornowske,

• Alicic, Radica Z., Providence St Joseph Health, Spokane, Washington, United States

Radica Z. Alicic,

• Bunke, Martin C., Travere Therapeutics Inc, San Diego, California, United States

Martin C. Bunke,

• Thakker, Kamlesh M., Travere Therapeutics Inc, San Diego, California, United States

Kamlesh M. Thakker,

• Amari, Diana T., Genesis Research LLC, Hoboken, New Jersey, United States

Diana T. Amari,

• Pinto, Lionel, Travere Therapeutics Inc, San Diego, California, United States

Lionel Pinto,

• Wang, Kaijun, Travere Therapeutics Inc, San Diego, California, United States

Kaijun Wang,

• Norris, Keith C., University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, United States

Keith C. Norris,

• Nicholas, Susanne B., University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, United States

Susanne B. Nicholas,

Group or Team Name

• CURE-CKD

Background

Focal segmental glomerulosclerosis (FSGS) is a glomerular disease that often progresses to kidney failure. The study aim was to evaluate clinical predictors associated with progression to kidney failure from real-world data.

Methods

Electronic health records from the Center for Kidney Disease Research, Education, and Hope (CURE-CKD) Registry were used to derive the study population from Providence and UCLA Health systems. Demographics, clinical characteristics, and prescription medications were obtained for adults ≥18 years old with FSGS in 2016-2020. Cox proportional hazards modeling was used to evaluate predictors of a primary composite outcome of 40% eGFR decline or eGFR <15 mL/min/1.73 m² (≥2 measures ≥90 days apart).

Results

Adults with FSGS (N=384) were 45% women and 51±18 (mean±SD) years old. At baseline, median CKD-EPI 2021 eGFR was 49 (interquartile range 30-77) mL/min/1.73 m²; UACR/UPCR were 1155 (323-2605) mg/g & 1.9 (0.8-3.4) g/g; systolic blood pressure was 130±15 mm Hg. Prescription medications included: ACE inhibitors/ARBs 72%, glucocorticoids 42%, calcineurin inhibitors 19%. Primary outcome events occurred in 118 (31%) patients. Median (IQR) follow-up time was 2 (1-3) years. Higher baseline eGFR, older age, and longer follow-up time were associated with lower risk of the primary outcome. Predictors of higher risk were hospitalization, treatment at Providence, ACE inhibitor/ARB use, and more outpatient visits (Figure). In a sensitivity analysis adding those with baseline UACR/UPCR measures (n=219), UACR >300 mg/g & UPCR >0.5 g/g yielded a HR=4.41 (1.65-11.80) and overall model stability.

Conclusion

Nearly one third of adults with FSGS progressed to 40% eGFR decline or kidney failure over a median of 2 years. Higher risks reflected in intensity of health care utilization and system, as well as by ACE inhibitor/ARB use, may reflect more severe illness.

Funding

• Commercial Support –