Kidney Week

Abstract: SA-PO0829

Mortality in Children and Adults with Glomerular Diseases in the CureGN Study

Session Information

• Glomerular Diseases: Management, Evolving Strategies, and Practice-Changing Advances
  October 24, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Glomerular Diseases

• 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics

Authors

• Kowalczyk, Sonya R., The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States

Sonya R. Kowalczyk, MD

• Helmuth, Margaret, University of Michigan Michigan Medicine, 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

• Zee, Jarcy, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States

Jarcy Zee, PhD, FASN

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

Zubin J. Modi, MD, MS

• Denburg, Michelle, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States

Michelle Denburg, MD

• Rao, Panduranga S., University of Michigan Michigan Medicine, Ann Arbor, Michigan, United States

Panduranga S. Rao, MD, MBBS, MS

• Mariani, Laura H., University of Michigan Michigan Medicine, Ann Arbor, Michigan, United States

Laura H. Mariani, MD, MS, FASN

Background

Children and adults with chronic kidney disease face increased mortality compared to the general population. While mortality in ESRD is well-documented, data are limited for patients with glomerular disease not requiring renal replacement therapy. This study provides updated mortality data for this population.

Methods

CureGN is an ongoing prospective observational cohort of patients with Minimal Change Disease, FSGS, Membranous Nephropathy, and IgA Nephropathy. Inclusion requires enrollment within 5 years of first biopsy, and patients with ESRD, transplant, or secondary causes at biopsy are excluded. Probability of mortality was estimated using Kaplan-Meier curves and risk factors were assessed using multivariable Cox proportional hazards models.

Results

Among 2,999 participants (MCD=660; FSGS=753; MN=651; IgAN=935), the median age at enrollment was 31 years (IQR 14-51) and 57% were male. Over a median follow up time of 6.3 years (IQR 2.8-8.8), a total of 94 deaths (3.1%) occurred at a median age of 64 years (IQR 28-74). Death rate per 1000 person-year were 2 (0-18 yrs), 1 (18-34 yrs), 4 (35-64 yrs), and 31 (65+ yrs). Leading causes of death were cardiac (21.3%), malignancy (11.7%), infection (7.4%), and ESRD (5.3%). Adjusting for enrollment age and eGFR, no statistically significant difference in hazard of death was detected between disease diagnoses. Compared to the 18-34 age group, participants 65+ had a 14.4 times higher hazard of death (HR 14.44, 95% CI 5.04, 41.40, p<0.0001); however, no significant differences were detected with younger ages. Each 10-unit decrease in eGFR at enrollment resulted in a 20% increase in hazard of death (HR 1.25 95% CI 1.15, 1.37, p<0.001).

Conclusion

Mortality was notably high across all ages in this study, driven primarily by age and baseline eGFR rather than disease diagnosis. Cardiovascular disease, malignancy and infection were the leading causes of death, highlighting the need for targeted risk management in these areas.

Probability of survival by disease diagnosis and age at enrollment

Funding

• NIDDK Support