Kidney Week

Abstract: FR-PO0860

Effect of Age on Clinical Outcomes and Pathology in Adults with Minimal Change Disease

Session Information

• Glomerular Outcomes: From Proteinuria to Prognosis
  November 07, 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

• Ryou, Seyoung, The Catholic University of Korea College of Medicine, Seocho-gu, Korea (the Republic of)

Seyoung Ryou, MD

• Min, Ji Won, The Catholic University of Korea College of Medicine, Seocho-gu, Seoul, Korea (the Republic of)

Ji Won Min, MD, PhD

• Ban, Tae Hyun, The Catholic University of Korea College of Medicine, Seocho-gu, Seoul, Korea (the Republic of)

Tae Hyun Ban, MD, PhD

• Koh, Eun Sil, The Catholic University of Korea College of Medicine, Seocho-gu, Seoul, Korea (the Republic of)

Eun Sil Koh, MD, PhD

• Eum, Sang Hun, The Catholic University of Korea College of Medicine, Seocho-gu, Seoul, Korea (the Republic of)

Sang Hun Eum, MD

• Hong, Yu Ah, The Catholic University of Korea College of Medicine, Seocho-gu, Seoul, Korea (the Republic of)

Yu Ah Hong, MD, PhD

• Chung, Byung ha, The Catholic University of Korea College of Medicine, Seocho-gu, Seoul, Korea (the Republic of)

Byung ha Chung, MD, PhD

• Kim, Hyung Wook, The Catholic University of Korea College of Medicine, Seocho-gu, Seoul, Korea (the Republic of)

Hyung Wook Kim

• Kim, Young soo, The Catholic University of Korea College of Medicine, Seocho-gu, Seoul, Korea (the Republic of)

Young soo Kim, MD, PhD

• Shin, Seok Joon, The Catholic University of Korea College of Medicine, Seocho-gu, Seoul, Korea (the Republic of)

Seok Joon Shin, MD, PhD

• Yoon, Hye Eun, The Catholic University of Korea College of Medicine, Seocho-gu, Seoul, Korea (the Republic of)

Hye Eun Yoon, MD, PhD

Background

Minimal change disease (MCD) shows a different clinical course in children and adults, but data on elderly patients remain limited. This study aimed to assess the impact of aging on the clinicopathologic features and prognosis of adult MCD.

Methods

A multicenter cohort of 115 biopsy-confirmed MCD patients was analyzed, stratified into elderly (≥65 years) and non-elderly (<65 years) groups. Histologic findings and clinical outcomes, including complete remission (CR), relapse, kidney replacement therapy (KRT), mortality, and treatment-related complications, were compared.

Results

A total of 83 non-elderly and 32 elderly patients were followed for a median of 26 months (interquartile range, 12-48). The elderly group had more severe glomerulosclerosis, mononuclear infiltration, interstitial fibrosis, tubular atrophy, acute tubular necrosis, and tubular casts (all, p<0.05). In elderly patients, tubular casts were more prevalent in those who achieved CR than in those who did not (50% versus 0%; p=0.004). The cumulative incidence of CR was significantly lower in the elderly group (62.5% vs. 84.3%; p=0.017). Rates of first relapse (35.0% versus 32.9%; p=0.9), KRT initiation (3.1% versus 1.2%; p=0.5), and mortality (6.3% versus 1.2%; p=0.2), and treatment complications did not differ between two groups. In multivariable Cox analysis, estimated glomerular filtration rate independently predicted CR [hazard ratio (HR) = 1.01; 95% confidence interval (CI), 1.00-1.02; p=0.026), and initial urine protein-to-creatinine ratio predicted relapse (HR = 1.20; 95% CI, 1.08-1.32; p<0.0001). Age was not an independent predictor for CR and relapse.

Conclusion

Elderly MCD patients showed more chronic histologic changes and lower CR rates, while other outcomes were comparable. Elderly MCD patients can be managed as other age groups, but sophisticated treatment strategy is warranted to improve their outcomes.

Cumulative incidence of (A) complete remission and (B) relapse in MCD patients by age group

Digital Object Identifier (DOI)

• doi: 10.1681/ASN.2025wqr7gawx