Kidney Week

Abstract: FR-OR030

Glomerular Disease Outcomes Across the Lifespan: Report of the Cure Glomerulonephropathy (CureGN) Research Consortium

Session Information

• Glomerular Disease Outcomes: Measuring What Matters
  November 07, 2025 | Location: Room 310A, Convention Center
  Abstract Time: 04:50 PM - 05:00 PM

Category: Glomerular Diseases

• 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics

Authors

• Helmuth, Margaret, University of Michigan, Ann Arbor, Michigan, United States

Margaret Helmuth, MA

• Smith, Abigail R., Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States

Abigail R. Smith, PhD

• Modi, Zubin J., University of Michigan, Ann Arbor, Michigan, United States

Zubin J. Modi, MD, MS

• Khalid, Myda, Riley Hospital for Children at Indiana University Health, Indianapolis, Indiana, United States

Myda Khalid, MD

• Sethna, Christine B., Cohen Children's Northwell Health Physician Partners Pediatric Nephrology and Kidney Transplant, New Hyde Park, New York, United States

Christine B. Sethna, MD, MEd

• Smoyer, William E., The Ohio State University, Columbus, Ohio, United States

William E. Smoyer, MD

• Greenbaum, Larry A., Emory University School of Medicine, Atlanta, Georgia, United States

Larry A. Greenbaum, MD, PhD

• Robinson, Bruce M., University of Michigan, Ann Arbor, Michigan, United States

Bruce M. Robinson, MD, MS, FASN

• Wang, Chia-Shi, Emory University School of Medicine, Atlanta, Georgia, United States

Chia-Shi Wang, MD, MS

Group or Team Name

• Cure Glomerulonephropathy Study Consortium.

Background

Direct comparisons of outcomes between adult and pediatric patients with primary glomerular disease (GD) are rare. We compared disease outcomes among patients with minimal change disease (MCD), focal segmental glomerulosclerosis (FSGS), membranous nephropathy (MN), and IgA nephropathy (IgAN) across the lifespan.

Methods

CureGN observational cohort participants enrolled from centers in North America and Europe and followed for at least 1 year were included. With age at biopsy as the primary predictor, we examined risk of death, ESKD, and ≥40% eGFR decline below 60ml/min/1.73m² stratified by histologic subtype and adjusted for sex, race/ethnicity, proteinuria at biopsy, and eGFR at biopsy in multivariable Cox regression.

Results

2,915 patients (MCD N=647, FSGS N=738, MN N=636, IgA N=894) with a median (IQR) of 5.6y (2.1-7.6) follow-up were included. Pediatric MCD patients had steeper eGFR declines compared to adults (-0.6 to -1.3 mL/min/1.73m² vs. -0.4 to +0.5 mL/min/1.73m², respectively), while MN patients aged 13-17 and FSGS and IgA patients aged 18-44y at time of biopsy had the steepest declines in eGFR among their diagnosis cohorts. For patients with MCD, FSGS, and MN, no differences were detected among various age groups in the risk of progression to the composite outcome of death, ESKD or ≥40% eGFR decline, while IgA patients aged 6-12y, 13-17y, and 45-64y had lower risks of progression compared to those aged 18-44y (HR [95% CI] 0.33 [0.17-0.62], 0.44 [0.24-0.81], 0.64 [0.43-0.96], respectively).

Conclusion

Patients with primary GD face similar risks for declines in kidney function regardless of the age at disease diagnosis. For younger patients, this represents a higher likelihood of reaching ESKD and requiring dialysis and/or transplant in their lifetimes.

Left - eGFR slope by age at biopsy diagnosis and histologic subtype among patients with primary glomerular disease. Right - Hazard ratios for the composite outcome of death, ESKD, or >=40% eGFR decline by age at biopsy diagnosis.

Funding

• NIDDK Support

Digital Object Identifier (DOI)

• doi: 10.1681/ASN.2025hbfxzjbj