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Abstract: SA-PO0797

Socioeconomic and Clinical Predictors of FSGS Progression

Session Information

Category: Glomerular Diseases

  • 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics

Authors

  • Unes, Meghan Marie, Saint Louis University School of Medicine, St. Louis, Missouri, United States
  • Aydin, Orhun, Saint Louis University, St. Louis, Missouri, United States
  • Barthel, Avrie, Saint Louis University School of Medicine, St. Louis, Missouri, United States
  • Gurbani, Sonja, Saint Louis University School of Medicine, St. Louis, Missouri, United States
  • Morgan, Kaydon J, Saint Louis University School of Medicine, St. Louis, Missouri, United States
  • Hibbard, Jacob, Saint Louis University School of Medicine, St. Louis, Missouri, United States
  • Truong, Dzuy, Saint Louis University School of Medicine, St. Louis, Missouri, United States
  • Befeler, Jaime, Saint Louis University School of Medicine, St. Louis, Missouri, United States
  • Rabideau, Kate, Saint Louis University School of Medicine, St. Louis, Missouri, United States
  • DeLonais-Parker, Ava, Saint Louis University School of Medicine, St. Louis, Missouri, United States
  • Lentine, Krista L., SSM Health Saint Louis University Hospital, St. Louis, Missouri, United States
  • Caliskan, Yasar, SSM Health Saint Louis University Hospital, St. Louis, Missouri, United States
Background

Focal segmental glomerulosclerosis (FSGS) commonly leads to nephrotic syndrome and end-stage kidney disease (ESKD). We investigated associations between demographics, socioeconomic factors, and FSGS progression in a diverse patient population.

Methods

This retrospective study included FSGS patients seen at SSM Health in the last 12 months. Data included demographics, BMI, age at kidney biopsy/diagnosis, family history, proteinuria, serum creatinine, eGFR, and American Community Survey (ACS)-based socioeconomic data by address. Labs recorded at baseline and follow-up. A Random Forest model identified key predictors (Figure 1) of ESKD, the primary outcome.

Results

Of 90 patients (mean age=41.54; 44.4% female), 42.2% developed ESKD. Mean follow-up was 5.83 years (median=4.16, IQR 1.42-8.45). Survival was 91.1%, and 23.3% showed family history. Higher initial serum creatinine increased ESKD risk (HR 1.24 [95% CI 1.14-1.36]), higher initial eGFR was protective (HR 0.98 [95% CI, 0.97-0.99]). Age at diagnosis had a borderline association (HR 1.02 [95% CI, 1.00-1.03]). Key ACS predictors were unemployment (11%), insurance status (10%), and housing cost burden (9%).

Conclusion

Population-level socioeconomic factors strongly predict progression to ESKD, and serum creatinine and eGFR at diagnosis are key clinical predictors. Further analyses will examine interactions between socioeconomic and clinical data to inform future care.

Digital Object Identifier (DOI)