Abstract: FR-PO0825
Effect of Clinical Remission on Major Adverse Kidney Outcomes in Older Adults with Glomerular Diseases
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
- Cordoba Hurtado, Angela Maria, Hospital General de Mexico Dr Eduardo Liceaga, Mexico City, CDMX, Mexico
- Rovin, Brad, Wexner Center for the Arts at The Ohio State University, Columbus, Ohio, United States
- Garcia Villalobos, Gloria, Hospital General de Mexico Dr Eduardo Liceaga, Mexico City, CDMX, Mexico
- Castañeda Meza, Valeria M., Hospital General de Mexico Dr Eduardo Liceaga, Mexico City, CDMX, Mexico
- Fonseca, Vanessa Agustin, Hospital General de Mexico Dr Eduardo Liceaga, Mexico City, CDMX, Mexico
Background
GD in older adults are associated with significant morbidity, reports on the specific prognostic factors remain scarce. We aimed to evaluate the spectrum of GD in older adults and identify factors associated with major adverse kidney events (MAKE) in a tertiary center in Mexico City
Methods
We conducted a retrospective cohort study of patients ≥60 years with biopsy-proven GD (2012–2025). The primary outcome was a composite MAKE, defined as renal replacement therapy(RRT), all-cause mortality, or a ≥30% decrease in eGFR. Survival and risk factors were assessed using univariate Cox proportional hazards models.
Results
A total of 112 patients were included (mean age 68±5.7years). Secondary GD accounted for 80% of cases. The most frequent etiologies were VVA (21%), membranous nephropathy(19%), diabetic nephropathy(DN) (18%), podocytopathies(18%), and paraproteinemia-related GD(17%). Regarding treatment response, 56% achieved a composite response (30%complete, 26%partial). During follow-up, 22% requires RRT, 6% died, and 37% were lost to follow-up. The overall MAKE rate was 39%(Figure 1). In univariate analysis, female sex, higher baseline eGFR, and lower baseline hb were associated with better outcomes, whereas secondary etiology was a strong risk factor for MAKE. Notably, DN portended the worst prognosis (HR 7.0, 95%CI 3–16, p=0.001). However, in the final Cox model, achieving clinical remission remained the strongest independent protector, conferring an 84% reduction in risk (Adjusted HR 0.156, 95% CI 0.052–0.465, p=0.001). This protective effect remained significant even when adjusted for etiology. HR 0.91, 95% CI 0.06-0.58, p=0.004
Conclusion
In this cohort of older adults, secondary GD predominate, with diabetic nephropathy carrying the highest risk for adverse outcomes. Nevertheless, achieving clinical remission is the most critical determinant of survival, significantly reducing the risk of MAKE regardless of the underlying etiology. These findings support pursuing therapeutic targets in the elderly to improve long-term kidney preservation.