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Kidney Week

Abstract: TH-PO614

Predictors of Major Adverse Kidney Disease Events in a Real-World Population with IgA Nephropathy

Session Information

Category: Glomerular Diseases

  • 1402 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

  • Tuttle, Katherine R., Providence Health and Services, Spokane, Washington, United States
  • Kornowske, Lindsey M., Providence Health and Services, Spokane, Washington, United States
  • Jones, Cami R., Providence Health and Services, Spokane, Washington, United States
  • Daratha, Kenn B., Providence Health and Services, Spokane, Washington, United States
  • Alicic, Radica Z., Providence Health and Services, Spokane, Washington, United States
  • Neumiller, Joshua J., Washington State University, Pullman, Washington, United States
  • Bensink, Mark Eliot, Travere Therapeutics Inc, San Diego, California, United States
  • Gong, Wu, Travere Therapeutics Inc, San Diego, California, United States
  • Norris, Keith C., University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, United States
  • Nicholas, Susanne B., University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, United States

Group or Team Name

  • CURE-CKD.
Background

IgA nephropathy (IgAN) is a glomerular disease that may progress to kidney failure. While albuminuria or proteinuria and reduced kidney function are associated with greater risk, other predictors are less clear. The study aim was to use a real-world population to assess clinical predictors of major adverse kidney disease events (MAKDE) in IgAN.

Methods

The study population was derived from electronic health records data in the Center for Kidney Disease Research, Education, and Hope (CURE-CKD) Registry at Providence and UCLA Health systems. Demographics, clinical characteristics, and prescriptions were obtained for adults ≥18 years old with a diagnosis code for IgAN in 2016-2020. Kaplan Meier survival analysis and Cox proportional hazards models evaluated MAKDE: 40% eGFR decline, eGFR <15 mL/min/1.73 m2, and administrative codes for kidney failure, dialysis, or transplant.

Results

Patients with IgAN (N=1,099) were 50% women (n=554) and 55±18 (mean±SD) years old. At baseline, mean eGFR was 77±28 mL/min/1.73 m2 (Chronic Kidney Disease Epidemiologic equation 2021); median urine albumin/creatinine ratio (UACR) and urine protein/creatinine ratio (UPCR) were 119 (interquartile range 30-518) mg/g and 0.7 (0.3-1.9) g/g. Renin angiotensin system (RAS) inhibitors and corticosteroids were prescribed to 49% (n=538) and 25% (n=278), respectively. MAKDE occurred in 13% (n=144) by 3 years. Predictors of MAKDE were Asian race, hospitalization, diabetes, RAS inhibitor use, and lower baseline eGFR (Figure). In a sensitivity analysis model including baseline UACR or UPCR measurements (n=335), levels above versus below the median had an adjusted hazard ratio of 2.10 (95% confidence interval 1.07-4.11).

Conclusion

MAKDE were common in patients with IgAN. Asian race and illness severity reflected by hospitalization, diabetes, and RAS inhibitor use, as well as reduced kidney function and albuminuria or proteinuria, predicted these events.

Funding

  • Commercial Support – Travere Therapeutics