Abstract: FR-PO0639
Partial Remission (PR) and FSGS-Specific Partial Remission (FSGSPR)as Surrogate Outcomes for Long-Term Kidney Survival: A Population-Based Study
Session Information
- Glomerular Diseases: Clinical, Outcomes, and Therapeutics Research - ANCA/FSGS
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
- Atiquzzaman, Mohammad, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
- Zhu, Bingyue, BC Provincial Renal Agency, Vancouver, British Columbia, Canada
- Er, Lee, BC Provincial Renal Agency, Vancouver, British Columbia, Canada
- Han, Jialin, BC Provincial Renal Agency, Vancouver, British Columbia, Canada
- Stoneman, Sinead, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
- Barbour, Sean, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
Background
PR and FSGSPR may serve as valid surrogate endpoint for kidney survival. It is unknown whether either one is better in primary vs secondary FSGS. We investigated trajectories of proteinuria over time and association between different definitions of proteinuria remission and risk of ESKD in primary vs secondary FSGS.
Methods
We used data from population-level glomerulonephritis registry from BC, Canada. Patients with FSGS diagnosed on a native kidney biopsy between Jan 1, 2000 and Dec 31, 2020 were included. Remissions were defined as complete remission (CR, proteinuria <0.3g/day), and two non-mutually exclusive definitions of PR: traditional (TPR, proteinuria decline by 50% and <3.5g/day) and FSGSPR (proteinuria decline by 40% from peak value prior each time point and <1.5g/day). Multivariable Cox models were used to model association between remission status and ESKD in primary vs. secondary FSGS.
Results
Study cohort included 1120 patients; 30% primary and 66% secondary FSGS. Median (IQR) age was 58 (43, 70) years, 62% males. CR occurred in 20%, TPR in 27%, FSGSPR in 25%; no remission in >50%. Compared to no remission, TPR reduced risk of ESKD by 68% and CR reduced risk of ESKD by 93% (Table1). Association of TPR and CR with risk of ESKD was similar in those with primary compared to secondary FSGS (interaction p-value: 0.6291). Again, FSGSPR reduced ESKD risk by 81% and CR reduced ESKD risk by 93%. Association between remission status and ESKD risk was different in primary compared to secondary FSGS (interaction p-value: 0.0111). For FSGSPR, risk was reduced more in primary FSGS (97%) compared to in secondary FSGS (66%) (Table 1). In a model that considered FSGSPR and TPR concurrently, largest reduction in risk was seen with FSGSPR (alone or with TPR) compared to TPR alone with no different in primary vs secondary FSGS (Table 1).
Conclusion
Our findings suggest that the risk of ESKD associated with being in FSGSPR was lower than that seen with being in TPR and protective effect of being in FSGSPR was more pronounced in those with primary compared to secondary FSGS.