Kidney Week

Abstract: FR-PO0861

Association Between Age-Adjusted Global Glomerulosclerosis with Progression of Kidney Disease in Patients with Idiopathic Membranous Nephropathy

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

• Kim, Sungmi, The Catholic University of Korea Eunpyeong St Mary's Hospital, Eunpyeong-gu, Seoul, Korea (the Republic of)

Sungmi Kim, MD

• Yoon, Hye Eun, The Catholic University of Korea Seoul St Mary's Hospital, Seocho-gu, Seoul, Korea (the Republic of)

Hye Eun Yoon, MD, PhD

• Lee, Hanbi, The Catholic University of Korea Seoul St Mary's Hospital, Seocho-gu, Seoul, Korea (the Republic of)

Hanbi Lee, MD

• Koh, Eun Sil, The Catholic University of Korea Yeouido Saint Mary's Hospital, Yeongdeungpo-gu, Seoul, Korea (the Republic of)

Eun Sil Koh, MD, PhD

• Hong, Suyeon, The Catholic University of Korea Uijeongbu St Mary's Hospital, Uijeongbu-si, Gyeonggi-do, Korea (the Republic of)

Suyeon Hong, MD, DrMed

• Kang, Donghyuk, The Catholic University of Korea Bucheon St Mary's Hospital, Bucheon-si, Gyeonggi-do, Korea (the Republic of)

Donghyuk Kang, MD

• Youn, Sojung, The Catholic University of Korea Bucheon St Mary's Hospital, Bucheon-si, Gyeonggi-do, Korea (the Republic of)

Sojung Youn, DrMed

• Kim, Byung soo, The Catholic University of Korea Eunpyeong St Mary's Hospital, Eunpyeong-gu, Seoul, Korea (the Republic of)

Byung soo Kim

• Choi, Bumsoon, The Catholic University of Korea Eunpyeong St Mary's Hospital, Eunpyeong-gu, Seoul, Korea (the Republic of)

Bumsoon Choi, MD

• Ban, Tae Hyun, The Catholic University of Korea Eunpyeong St Mary's Hospital, Eunpyeong-gu, Seoul, Korea (the Republic of)

Tae Hyun Ban, MD, PhD

• Kim, Hyung Duk, The Catholic University of Korea Eunpyeong St Mary's Hospital, Eunpyeong-gu, Seoul, Korea (the Republic of)

Hyung Duk Kim, MD

• Kim, Hyunglae, Division of Nephrology, Department of Internal Medicine, St. vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea (the Republic of)

Hyunglae Kim, MD

• Eum, Sang Hun, The Catholic University of Korea Incheon Saint Mary's Hospital, Incheon, Korea (the Republic of)

Sang Hun Eum, MD

• Chang, Yoon-Kyung, The Catholic University of Korea Daejeon St Mary's Hospital, Daejeon, Korea (the Republic of)

Yoon-Kyung Chang, MD, PhD

• Park, Hwajin, The Catholic University of Korea Daejeon St Mary's Hospital, Daejeon, Korea (the Republic of)

Hwajin Park, MD

• Han, Suyeon, The Catholic University of Korea Daejeon St Mary's Hospital, Daejeon, Korea (the Republic of)

Suyeon Han, MD

• Hwang, Yunkyeong, The Catholic University of Korea Daejeon St Mary's Hospital, Daejeon, Korea (the Republic of)

Yunkyeong Hwang, MD

• Hong, Yu Ah, The Catholic University of Korea Daejeon St Mary's Hospital, Daejeon, Korea (the Republic of)

Yu Ah Hong, MD, PhD

Background

Idiopathic membranous nephropathy is the major cause of nephrotic syndrome in older adults. This study aims to identify the association between age-adjusted global glomerulosclerosis and kidney disease progression and treatment response in patients with idiopathic membranous nephropathy.

Methods

This retrospective study included 170 patients diagnosed with idiopathic membranous nephropathy between 2015 and 2023. Patients were categorized into three groups based on the age-related thresholds of global glomerulosclerosis: no glomerulosclerosis, glomerulosclerosis normal for age, glomerulosclerosis abnormal for age. Kidney disease progression was defined as a ≥30% decline in estimated glomerular filtration rate (eGFR) from baseline. Complete and partial remission were assessed based on the degree of proteinuria reduction and normalization of serum albumin levels.

Results

The median follow-up duration was 42 months (interquartile range 23–66). Kidney disease progression occurred in 49 individuals (28.8%), while 38 (22.4%) and 127 (74.7%) achieved complete and overall remission at 6 months, respectively. In multivariable analysis, global glomerulosclerosis abnormal for age was independently associated with an increased risk of kidney disease progression compared with no global glomerulosclerosis (hazard ratio 2.57; 95% CI 1.34–5.81; P = 0.02). However, both global glomerulosclerosis normal for age and global glomerulosclerosis abnormal for age groups showed no significant association with achieving complete remission at 6 months compared with no global glomerulosclerosis group in multivariable analysis. Over the 24-month follow-up, the decline in eGFR was more marked in the glomerulosclerosis abnormal for age group compared to the other groups (P < 0.01), whereas percentage changes in proteinuria did not differ significantly (P = 0.23).

Conclusion

This study highlights that age-adjusted global glomerulosclerosis is associated with kidney disease progression but not with treatment response regarding remission in patients with idiopathic membranous nephropathy.

Digital Object Identifier (DOI)

• doi: 10.1681/ASN.20255vd7j830