Kidney Week

Abstract: TH-PO0371

Arterial Lesions in Primary Podocytopathies in Young Adults Are Associated with Glomerular Vascular Endothelial Growth Factor Expression and Poorer Kidney Outcomes

Session Information

• Glomerular Diseases: Genetics to Therapeutics
  October 22, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Glomerular Diseases

• 1401 Glomerular Diseases: Mechanisms, including Podocyte Biology

Authors

• Braga Barbosa, Gessica Sabrine, Universidade de Sao Paulo, São Paulo, SP, Brazil

Gessica Sabrine Braga Barbosa, MD

• Ledesma, Felipe Lourenco, Universidade de Sao Paulo, São Paulo, SP, Brazil

Felipe Lourenco Ledesma

• Camara, Niels Olsen Saraiva, Universidade de Sao Paulo, São Paulo, SP, Brazil

Niels Olsen Saraiva Camara, MD, PhD

• Oliveira, Ivone Braga de, Universidade de Sao Paulo, São Paulo, SP, Brazil

Ivone Braga de Oliveira, MD

• Dias, Cristiane B., Universidade de Sao Paulo, São Paulo, SP, Brazil

Cristiane B. Dias, MD

Background

Vascular endothelial growth factor (VEGF) is the major mediator of abnormal angiogenesis in diabetic glomeruli. The role of arterial lesions (AL) and VEGF expression in non-diabetic and young individuals with primary podocytopathies has received little attention.

Methods

We analyzed primary FSGS and MCD in young adults, dividing them into 2 groups according to presence or absence of histological AL (arteriosclerosis, AS; arteriolar hyalinosis, AH). VEGF-A expression was evaluated by immunohistochemistry (IHC).

Results

Based on 40 cases of podocytopathy with available tissue to perform IHC, 22 had AL (AS in 40%, AH in 32%, and AS + AH in 27%). The AL group presented with higher mean age (33 ±8 vs 26 ±10, p 0.02), with no difference in proportion of hypertension (36% vs 31%). The AL group presented with lower kidney function at the diagnosis (102 vs 127.5 ml/min/1.73m², p 0.008), most notably when AS + AH were presented (69.5 vs 127.5, p 0.01). After 4 years, the AL group also had the lowest eGFR (91.5 vs 117.5, p 0.005), especially when AS + AH were identified (57 vs 117.5, p 0.003). No difference in global sclerosis and IFTA was found. The performed IHC revealed higher glomerular VEGF expression in AL group (10.9 vs 3.9, p 0.017, Figure 1), most notably when AS + AH were found (Table 1).

Conclusion

Young adults with primary podocytopathy-associated arterial lesions (arteriosclerosis / arteriolar hyalinosis) have a poorer renal prognosis. Higher glomerular VEGF expression in podocytopathies with arterial lesions suggests an imbalance between dysregulated podocytes and vascular endothelial homeostasis.