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Abstract: TH-PO476

GSTM1 Deletion Associates With Progression of Glomerular CKD

Session Information

Category: Glomerular Diseases

  • 1303 Glomerular Diseases: Clinical‚ Outcomes‚ and Trials

Authors

  • Levy, Rebecca, University of Rochester Medical Center, Rochester, New York, United States
  • Reidy, Kimberly J., Albert Einstein College of Medicine, Bronx, New York, United States
  • Kaskel, Rick, Albert Einstein College of Medicine, Bronx, New York, United States
  • Le, Thu H., University of Rochester Medical Center, Rochester, New York, United States
  • Melamed, Michal L., Albert Einstein College of Medicine, Bronx, New York, United States

Group or Team Name

  • NEPTUNE Investigators
Background

Risk factors for progression in glomerular disease are not well-understood. A common deletion in GSTM1 is associated with progression in a variety of CKD etiologies but has not been previously reported in glomerular disease.

Methods

We performed a secondary analysis of the prospective NEPTUNE cohort. The exposure is ≥1 copy of nonfunctional GSTM1. The primary outcome is 40% reduction in eGFR or ESKD. Secondary outcomes include proteinuria remission and relapse. Analysis was by multivariable logistic regression with adjustment for potential confounders.

Results

Baseline characteristics of the study cohort are shown in Table 1. Of the 513 subjects, 60% were male, 57% were White, and they had a mean age of 30.4. At baseline, subjects with GSTM1 deletion were younger with worse kidney function; they were more likely to have FSGS and self-identify as Black. Participants were followed for a mean of 2.4±1.6 years; 118 participants developed the primary outcome, 88 (23%) in the GSTM1 1/1 group and 30 (32%) in the GSTM1 deletion group. After adjustment for demographics and baseline severity, GSTM1 deletion is associated with progression of CKD (OR 1.91, CI 1.12-3.27) but not with changes in proteinuria.

Conclusion

GSTM1 deletion is associated with progression of CKD in glomerular disease but unlikely involves proteinuric pathways in this cohort.

 Total (n=513)Reference (n=406)Deletion (n=107)p
Age30.4±22.331.7±22.824.9±18.90.006
Male308 (60%)245 (60%)63 (59%)0.8
Race   <0.001
Multiracial24 (4.8%)17 (4.2%)7 (7.0%) 
Native American1 (0.2%)01 (1.0%) 
Asian57 (11%)57 (14%)0 
Black112 (22%)34 (8.5%)78 (79%) 
Pacific Islander2 (0.4%)2 (0.5%)0 
White287 (57%)281 (70%)6 (6.1%) 
Unknown18 (3.6%)11 (2.7%)7 (7.1%) 
Hispanic107 (21%)92 (23%)15 (15%)0.1
Diagnosis   <0.001
Membranous83 (17%)77 (21%)6 (5.9%) 
Minimal Change146 (31%)122 (33%)24 (24%) 
FSGS158 (33%)107 (29%)51 (50%) 
Other89 (19%)68 (18%)21 (21%) 
Baseline    
eGFR84.2±38.186.5±37.573.4±38.80.002
UPCR4.2±6.34.3±6.73.9±4.20.6
HTN214 (43%)172 (43%)42 (42%)0.9