Kidney Week

Abstract: FR-PO0834

Long-Term Remission Off Therapy in Primary Glomerular Diseases: Insights from Cure Glomerulonephropathy (CureGN)

Session Information

• Glomerular Diseases: Practice and New Concepts Shaping Modern Care
  October 23, 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

• Wyatt, Nicole Elizabeth, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States

Nicole Elizabeth Wyatt, DO

• Lancki, Nicola, Northwestern University, Evanston, Illinois, United States

Nicola Lancki, MPH

• Peleg, Yonatan A., Northwestern University, Evanston, Illinois, United States

Yonatan A. Peleg, MD

• Ayoub, Isabelle, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States

Isabelle Ayoub, MD, MPH, FASN

• Parsa, Afshin, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland, United States

Afshin Parsa, MD, MPH, FASN

• Kidd, Jason M., VCU Medical Center Main Hospital, Richmond, Virginia, United States

Jason M. Kidd, MD, FASN

• Derebail, Vimal K., The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States

Vimal K. Derebail, MD, MPH, FASN

• Bomback, Andrew S., Columbia University, New York, New York, United States

Andrew S. Bomback, MD, MPH

• Smith, Abigail R., Northwestern University, Evanston, Illinois, United States

Abigail R. Smith, PhD

Group or Team Name

• CureGN LTROT Working Group

Background

Primary glomerular diseases including focal segmental glomerulosclerosis (FSGS), minimal change disease (MCD), IgA nephropathy (IgAN), and membranous nephropathy (MN) demonstrate heterogeneous clinical courses and treatment responses. Some patients achieve sustained remission after discontinuation of immunosuppression, but predictors of long-term remission off therapy (LTROT) remain poorly defined. Using longitudinal data from CureGN, we characterized patients achieving LTROT and their progression across disease cohorts.

Methods

CureGN participants with MCD, FSGS, MN, or IgAN and ≥5 years of follow-up were included. LTROT was defined as ≥5 years without immunosuppressive therapy and no evidence of disease activity based on previously published CureGN disease activity criteria. Demographic, clinical, laboratory, and pathology data at the time of biopsy or at study enrollment were summarized and compared between LTROT and non-LTROT groups. Linear mixed-effects models assessed eGFR trajectories by LTROT status, stratified by disease type.

Results

Among 1,698 participants, 370 (22%) achieved LTROT, with the highest prevalence in MCD (28%) and MN (26%), followed by FSGS (21%) and IgAN (14%). In the non-LTROT group (n=1328), 141 patients were noted to be in remission on therapy. Patients achieving LTROT had preserved kidney function, lower proteinuria at enrollment, and tended to have less chronic histopathologic features when core scoring was available (Table 1). In adjusted models, patients not achieving LTROT had steeper declines in eGFR.

Conclusion

These findings suggest that a subset of patients can safely maintain LTROT and highlight the importance of identifying predictors of treatment independence. Future work will focus on multivariable prediction models incorporating clinical, histopathologic, and biomarker data to guide individualized immunosuppression strategies and improve long-term outcomes.

Characteristics by Disease Type and Activity

median (IQR); n/N (%); eGFR (mL/min/1.73 m2); UPCR (g/g)

Funding

• NIDDK Support