Abstract: SA-PO0855
Timing and Patterns of Diagnosis in Glomerular Kidney Diseases
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
- Snow, Todd, Baylor College of Medicine, Houston, Texas, United States
- Walther, Carl P., Baylor College of Medicine, Houston, Texas, United States
Background
There currently exists a gap in knowledge on the time that elapses between initial presentation and definitive diagnosis of glomerular disease by biopsy, as well as factors that delay diagnosis.
Methods
We identified all patients in a safety-net health system who underwent kidney biopsy within a one-year period. Demographics, laboratory values, and care pathways were obtained by chart review. Time to diagnosis was defined as the interval between the first reported symptom or laboratory abnormality and kidney biopsy. Univariate and multivariate Cox proportional-hazards models were used to evaluate associations between time to diagnosis and patient demographics, comorbidities, and initial presenting symptoms or laboratory abnormalities.
Results
Among 185 patients who underwent kidney biopsy, 59 were newly diagnosed with glomerular disease. Median time to diagnosis was 204 days overall and 1,527 days for patients diagnosed in the outpatient setting. Among patients diagnosed in the outpatient setting, time from nephrology visit to biopsy was not correlated with time to diagnosis (r = -0.086, p = 0.69). Older age was associated with delayed diagnosis (HR 0.98, p = 0.035), corresponding to a 2% yearly increase in hazard. After controlling for comorbidities and diagnosis, female sex was associated with a 47% increased hazard of delayed diagnosis (p = 0.038).
Conclusion
A substantial delay exists between initial presentation of glomerular disease and definitive diagnosis by kidney biopsy, particularly in the outpatient setting. Time from nephrology evaluation to biopsy was not associated with overall time to diagnosis, suggesting delays occur prior to nephrology involvement. Older age and female sex were associated with delayed diagnosis. These findings highlight the need for early recognition of glomerular disease and prompt nephrology referral across all patient populations.