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Kidney Week

Abstract: TH-PO618

Levels of Socioeconomic Deprivation Are Associated with Worse Kidney Outcomes in Patients with IgA Nephropathy: Data from UK RaDaR

Session Information

Category: Glomerular Diseases

  • 1402 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

  • Barratt, Jonathan, University of Leicester, Leicester, United Kingdom
  • Pitcher, David, UK Kidney Association, Bristol, United Kingdom
  • Wong, Katie, UK Kidney Association, Bristol, United Kingdom
  • Lightstone, Liz, Imperial College London, London, London, United Kingdom
  • Gale, Daniel P., UK Kidney Association, Bristol, United Kingdom
Background

The UK National Registry of Rare Kidney Diseases (RaDaR) recruits adults and children with biopsy-proven primary IgA nephropathy (IgAN) and eGFR <60 mL/min/1.73m2 or proteinuria ≥0.5g/24h from 107 adult and paediatric kidney units across the UK, including retrospective and prospective data. Given the well established gradient between greater socioeconomic deprivation and worse health, in this study we aimed to determine whether socioeconomic deprivation influenced the risk of developing kidney failure in IgAN.

Methods

Deprivation quintile was derived using patient postcodes matched to Index of Multiple Deprivation (IMD) scores. Kidney survival from diagnosis was analysed using Kaplan Meier methods and Cox regression. The event was initiation of kidney replacement therapy, censored for death.

Results

The characteristics of 4,127 IgAN patients in RaDaR by IMD quintiles are shown in the Table. There was a clear association between risk of development of kidney failure and deprivation quintile (Figure) with the most deprived IgAN patient group exhibiting significantly faster progression. HR for kidney failure after adjustment for age, eGFR at diagnosis and gender for IMD1 vs 3 quintile: 1.46 (1.15-1.84), p=0.0017.

Conclusion

Outcomes in this large IgAN cohort have been published and shown to be poor with few patients expected to avoid kidney failure in their lifetime. This analysis demonstrates even worse outcomes if more socioeconomically deprived & highlights the need to develop strategies to ensure equity of access not only to early diagnosis but also to the new therapies that are showing promise in preventing kidney failure in IgAN.

IMD QuintilesAge at diagnosis
(median, 25th & 75th pctl)
Gender (M/F)
(% IMD quintile)
White/ non-White (%)eGFR at diagnosis
(median, 25th & 75th pctl)
Time to kidney failure
(median, 95% CI)
1- most deprived38.9 (28.4, 51.2)67.3/32.775.2/25.838 (21, 69)7.9 (6.9, 9.3)
341.0 (29.4, 51.9)69.9/30.186.2/13.839 (22, 70)10.4 (9.0, 12.6)
5- least deprived41.6 (30.6, 55.0)74.3/25.788.5/11.537 (22, 68)12.4 (11.1, 13.5)