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Kidney Week

Abstract: TH-PO0762

Clinical and Histopathological Characteristics of Kidney Biopsies in a Tertiary Care Hospital in Mexico, 2012-2024: Temporal Trends and Diagnostic Patterns

Session Information

Category: Glomerular Diseases

  • 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics

Authors

  • Cordoba Hurtado, Angela Maria, Hospital General de Mexico Dr Eduardo Liceaga, Mexico City, CDMX, Mexico
  • Perez-Navarro, L. Monserrat, Hospital General de Mexico Dr Eduardo Liceaga, Mexico City, CDMX, Mexico
  • Soto, Virgilia, Instituto Nacional de Cardiologia Ignacio Chavez, State of Mexico, Méx., Mexico
  • Valdez-Ortiz, Rafael, Hospital General de Mexico Dr Eduardo Liceaga, Mexico City, CDMX, Mexico
  • Rojas-Rivera, Jorge Enrique, The Ohio State University, Columbus, Ohio, United States
  • Rovin, Brad, The Ohio State University, Columbus, Ohio, United States
Background

Glomerular diseases (GD) are heterogenous diseases. Latin populations have a high risk of adverse outcomes. Here we evaluated long term outcomes of GD, including progression to chronic kidney disease, end-stage kidney disease (ESKD) and mortality, stratified by primary and secondary subtypes.

Methods

This is a retrospective cohort study of adult patients with biopsy proven GD at General Hospital of Mexico, from 2012 to 2024, Outcomes were mortality and progression to ESKD, stratified by GD subtype. Data were analyzed descriptively, Cox regression was used to estimate hazard ratios (HR) with 95% confidence intervals. A p-value<0,05 was considered significant.

Results

1,009 patients (60% female) were analyzed with a mean age of 39±14.6 years. Hypertension and diabetes were present in 19% and 14% respectively. 79% had GD secondary to a systemic process and this trend increased over time (2012–2015, 78% 2016–2019, 75% 2020-2024, 84% p=0,014). This was driven mainly by an increase in lupus nephritis (32%, 31%, 41% respectively). Lupus nephritis was the leading cause of secondary GD (45.7%) followed by diabetic nephropathy (13%) and vasculitis (12%). FSGS was the most frequent primary GD (43%), followed by membranous (24%) and IgA (20%) nephropathy. Overall mortality was 7.8%, mostly due to infections (80%). Secondary GD were associated with higher mortality (HR 2.7, 95%CI 1.07-6.7, p=0.03). At last follow-up 19% required renal replacement therapy. Secondary GD had higher risk of ESKD risk (HR 2.8, 95%CI 1,63-4.8, p<0,001) Figure.

Conclusion

This large biopsy cohort reveals a growing predominance of secondary GN particularly lupus nephritis, associated with higher mortality and ESKD risk. Understanding the local epidemiology is crucial to guide therapeutic strategies, reduce adverse outcomes, and inform public health policies aimed to improving prognosis in these high risk populations.

Digital Object Identifier (DOI)