Abstract: SA-PO0804
Kidney Outcomes in IgAN Across the Age Spectrum in the Cure Glomerulopathy Network (CureGN)
Session Information
- Glomerular Research: Design, Registries, Surveys, and Epidemiology
November 08, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Glomerular Diseases
- 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics
Authors
- Khalid, Myda, Indiana University School of Medicine, Indianapolis, Indiana, United States
- Helmuth, Margaret, University of Michigan, Ann Arbor, Michigan, United States
- Smerdon, Caroline, University of Michigan, Ann Arbor, Michigan, United States
- Madison, Terri, Madison Epi Solutions LLC, Ann Arbor, Michigan, United States
- Mariani, Laura H., University of Michigan, Ann Arbor, Michigan, United States
- Pesce, Giancarlo, Certara Inc, Radnor, Pennsylvania, United States
- Reich, Heather N., University of Toronto, Toronto, Ontario, Canada
- Bomback, Andrew S., Columbia University, New York, New York, United States
Background
There is sparse literature on IgAN outcomes across the age spectrum. Understanding disease trajectories by age at presentation is paramount. We report differences in histology and renal outcomes by age.
Methods
CureGN is a prospective cohort study of adults and children with biopsy-proven glomerular disease. Descriptive statistics compared participant characteristics. Multivariable Cox proportional hazard models were fit to assess the relationship between age at enrollment and kidney failure (KF) outcomes. The effect of age on estimated glomerular filtration rate (eGFR) slope was evaluated using multivariable linear mixed models. Models were adjusted for race, eGFR, proteinuria, and time from biopsy to enrollment.
Results
Included 653 participants with IgAN (enrollment age 6-12: n=59, 13-17: n=102, 18-44: n=309, 45-64: n=152 and 65+: n=31). Most were males (59%), white (80%) and non-Hispanic (85%). Median follow up time was 5.8 years (IQR: 1.7, 8.0). Age 18-44 yrs was the reference category. Hazard ratio (HR) for 40% decline in GFR or KF was highest in 13-17 yrs (HR 2.4; 95% confidence interval [CI] (1.13-5.13) and lowest in ages 65+ (0.35; 95% CI 0.13-0.98). Steepest eGFR decline was in 18-44 yrs (n=309) at -2.3 ml/min/1.73m2. Comparing MEST-C scores by age (n=286 patients with pathology), a significant difference in mesangial cellularity, segmental sclerosis and tubular atrophy was observed. Participants 18-44 yrs tended to have higher MEST-C scores.
Conclusion
In CureGN, participants 13-44 yrs of age with IgAN had a high risk of eGFR decline and worse outcomes compared with other age groups therefore adolescence and young adulthood may be an important intervention window.
eGFR slope by age at enrollment, HR of 40% decline or kidney failure and Radar plots of MEST-C score comparisons by age at biopsy.
Funding
- NIDDK Support – Calliditas Therapeutic