Kidney Week

Abstract: FR-PO0867

Incidence, Clinical Characteristics, and Outcomes of AKI in Patients with Nephrotic Syndrome

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

• Tsotsorou, Ourania, Department of Nephrology, National and Kapodistrian University of Athens, “Attikon” University Hospital, Athens, Attica, Greece

Ourania Tsotsorou, MD

• Gourdoupari, Eftychia Eirini Maria, Department of Nephrology, National and Kapodistrian University of Athens, “Attikon” University Hospital, Athens, Attica, Greece

Eftychia Eirini Maria Gourdoupari, MD

• Liapis, Georgios, 1st Department of Pathology, National Kapodistrian University of Athens, Athens, Attica, Greece

Georgios Liapis

• Gkiolas, Konstantinos, Department of Nephrology, National and Kapodistrian University of Athens, “Attikon” University Hospital, Athens, Attica, Greece

Konstantinos Gkiolas, MD

• Nikolopoulos, Petros, Department of Nephrology, National and Kapodistrian University of Athens, “Attikon” University Hospital, Athens, Attica, Greece

Petros Nikolopoulos, PhD

• Drouzas, Konstantinos, Department of Nephrology, National and Kapodistrian University of Athens, “Attikon” University Hospital, Athens, Attica, Greece

Konstantinos Drouzas, MD, MPH

• Lionaki, Sophia, Department of Nephrology, National and Kapodistrian University of Athens, “Attikon” University Hospital, Athens, Attica, Greece

Sophia Lionaki, MD, PhD

Background

Acute kidney injury (AKI) may complicate the course of nephrotic syndrome (NS), as a result of various pathogenetic mechanisms. The aim of this study is to evaluate the frequency of AKI among patients with NS, newly diagnosed or recurrent, and describe the related characteristics and outcomes of these patients.

Methods

We retrospectively reviewed the medical charts of the patients who received a diagnosis of NS from 2/2021 to 2/2025 in our department. Demographics, histopathological findings, clinical and laboratory data at diagnosis and thereafter were recorded. All the episodes of AKI during the follow up time were also recorded.

Results

A total of 70 patients with a new diagnosis, or recurrence of NS were identified, of whom 18(25.7%) experienced at least one AKI episode. Overall, the mean age was 55.2(±17.4)years, and 10(55.6%) were males. Podocytopathy was the most frequent histopathological diagnosis including 11/18(61.1%)cases. In total the following histopathological diagnoses were recorded: membranous glomerulopathy 4(23.8%), minimal change disease 4(23.8%), focal glomerulosclerosis 3(16.7%), SLE 3(16.7%), IgAN 1(5.6%), amyloidosis 1(5.6%). Two patients did not undergo a kidney biopsy, due to special conditions. At the time of NS diagnosis serum creatinine was 2.2(±1.3)mg/dl, eGFR 46.5(±36.9)ml/min/1.73m², serum albumin 2.55(±0.65)mg/dl, 24-hour urine protein 11.5(±6.1)g. The time to the first AKI episode was 6.8(±13.6)months from the diagnostic kidney biopsy. In total, 20 episodes of AKI were recorded. Nine patients (50%) experienced AKI at the time of NS diagnosis. In 8(40%) cases AKI was classified as stage I, in 3(15%) as stage II, and in 9(45%) as stage ΙΙΙ. Patients with AKI stage III had a more severe proteinuria compared to all others. Overall, 6 patients (33%) needed acute hemodialysis. During a follow-up time of 2.2(±1.3)years, all but two patients with AKI had a recovery of kidney function, with serum creatinine of 1.8(±1.1)mg/dl and 9(50%) had achieved complete remission of NS.

Conclusion

According to our findings from this small cohort of patients with NS, the occurrence of AKI in this population was relatively frequent, especially for patients with podocytopathies and carries significant morbidity.

Digital Object Identifier (DOI)

• doi: 10.1681/ASN.2025pjtfqsvq