Risk Factors for Disease Progression for Adults and Children With Membranous Nephropathy in the Cure Glomerulonephropathy Network (CureGN)

Risk Factors for Disease Progression for Adults and Children With Membranous Nephropathy in the Cure Glomerulonephropathy Network (CureGN)

Introduction: Primary membranous nephropathy (pMN) is a frequent cause of nephrotic syndrome in adult patients without diabetes. Recognizing the major shift in the classification of pMN based on target antigen and the management of patients with pMN with more widespread use of rituximab (RTX), we so...

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Main Authors: Louis-Philippe Laurin, Margaret Helmuth, Salem Almaani, Isabelle Ayoub, Dhruti P. Chen, Leonela A. Villegas, Cynthia C. Nast, Bruce M. Robinson, Vimal K. Derebail, Meryl Waldman, Andrew S. Bomback, Wooin Ahn, Gerald Appel, Paul Appelbaum, Revekka Babayev, Andrew Bomback, Pietro Canetta, Brenda Chan, Vivette Denise D'Agati, Samitri Dogra, Hilda Fernandez, Ali Gharavi, William Hines, Syed Ali Husain, Namrata Jain, Krzysztof Kiryluk, Fangming Lin, Maddalena Marasa, Glen Markowitz, Hila Milo Rasouly, Sumit Mohan, Nicola Mongera, Jordan Nestor, Thomas Nickolas, Jai Radhakrishnan, Maya Rao, Simone Sanna-Cherchi, Shayan Shirazian, Michael Barry Stokes, Natalie Uy, Anthony Valeri, Natalie Vena, Bartosz Foroncewicz, Barbara Moszczuk, Krzysztof Mucha, Agnieszka Perkowska-Ptasińska, Gian Marco Ghiggeri, Francesca Lugani, Josephine Ambruzs, Helen Liapis, Rossana Baracco, Amrish Jain, Isa Ashoor, Diego Aviles, Tarak Srivastava, Sun-Young Ahn, Prasad Devarajan, Elif Erkan, Donna Claes, Hillarey Stone, Sherene Mason, Rasheed Gbadegesin, Liliana Gomez-Mendez, Larry Greenbaum, Chia-shi Wang, Hong (Julie) Yin, Yi Cai, Goebel Jens, Julia Steinke, Donald Weaver, Jerome Lane, Carl Cramer, Cindy Pan, Neil Paloian, Rajasree Sreedharan, David Selewski, Katherine Twombley, Corinna Bowers, Mary Dreher, Mahmoud Kallash, John Mahan, Samantha Sharpe, William Smoyer, Amira Al-Uzri, Sandra Iragorri, Myda Khalid, Craig Belsha, Joseph Alge, Michael Braun, A.C. Gomez, Scott Wenderfer, Tetyana Vasylyeva, Daniel Feig, Gabriel Cara Fuentes, Melisha Hannah, Carla Nester, Aftab Chishti, Jon Klein, Chryso Katsoufis, Wacharee Seeherunvong, Michelle Rheault, Craig Wong, Nisha Mathews, John Barcia, Agnes Swiatecka-Urban, Sharon Bartosh, Tracy Hunley, Vikas Dharnidharka, Joseph Gaut, Louis-Philippe Laurinc, Virginie Royal, Anand Achanti, Milos Budisavljevicc, Sally Self, Cybele Ghossein, Yonatan Peleg, Shikha Wadhwanic, Tibor Nadasdy, Samir Parikh, Brad Rovinc, Anthony Chang, Huma Fatima, Bruce Julian, Jan Novak, Matthew Renfrow, Dana Rizkc, Dhruti Chen, Vimal Derebail, Ronald Falka, Keisha Gibson, Dorey Glenn, Susan Hogan, Koyal Jain, J. Charles Jennette, Amy Mottlc, Caroline Poultonb, Manish Kanti Saha, Agnes Fogo, Neil Sanghanic, Jason Kidd, Selvaraj Muthusamy, Jeffrey Schelling, Jean Houa, Kevin Lemley, Warren Mika, Pierre Russo, Michelle Denburg, Amy Kogon, Kevin Meyers, Madhura Pradhan, Raed Bou Matar, John O'Toole, John Sedor, Christine Sethna, Suzanne Vento, Mohamed Atta, Serena Bagnasco, Alicia Neu, John Sperati, Sharon Adler, Tiane Dai, Ram Dukkipati, Fernando Fervenza, Sanjeev Sethi, Frederick Kaskel, Kaye Brathwaite, Kimberly Reidy, Joseph Weisstuch, Ming Wu, Olga Zhdanova, Jurgen Heymann, Jeffrey Kopp, Cheryl Winkler, Katherine Tuttle, Jill Krissberg, Richard Lafayette, Kamal Fahmeedah, Elizabeth Talley, Michelle Hladunewich, Rulan Parekh, Carmen Avila-Casado, Daniel Cattran, Reich Heather, Philip Boll, Yelena Drexler, Alessia Fornoni, Brooke Blazius, Jeffrey Hodgin, Andrea Oliverio, Jon Hogan, Lawrence Holzman, Matthew Palmer, Gaia Coppock, Blaise Abromovitz, Michael Mortiz, Charles Alpers, J. Ashley Jefferson, Elizabeth Brown, Kamal Sambandam, Bethany Roehm, John Graff. a, Cynthia Nast, Laura Barisoni, Abigail Smith, Brenda Gillespie, Bruce Robinson, Matthias Kretzler, Laura Mariani, Lisa M. Guay-Woodford
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:Kidney International Reports
Subjects:
clinical outcomes
cohort study
immunosuppression
membranous nephropathy
risk factors
Online Access:http://www.sciencedirect.com/science/article/pii/S2468024925001706
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Summary:Introduction: Primary membranous nephropathy (pMN) is a frequent cause of nephrotic syndrome in adult patients without diabetes. Recognizing the major shift in the classification of pMN based on target antigen and the management of patients with pMN with more widespread use of rituximab (RTX), we sought to better characterize the clinical course and risk factors in adults and children with pMN. Methods: We used the Cure Glomerulonephropathy (CureGN) prospective cohort of patients with pMN diagnosed using biopsy between 2010 and 2023. We report time to kidney outcomes using adjusted Cox proportional hazards models. Results: In total, 591 patients (537 adults and 54 children) were evaluated with 9% reaching kidney failure. Anti–B cell therapy was used in 44% of patients. Age < 18 years, self-reported Black/African American race, proteinuria > 3 g/g, and lower estimated glomerular filtration rate (eGFR) at enrollment were associated with worse kidney survival. Black race (adjusted hazard ratio [HR]: 1.8; 95% confidence interval [CI]: 1.1–2.9) and age < 18 years (adjusted HR: 3.7; 95% CI: 2.0–7.1) were associated with an increased risk of kidney failure and/or > 40% eGFR decline after adjusting for exposure to immunosuppression. Latinx ethnicity was associated with a lower likelihood of reaching complete proteinuria remission (adjusted HR: 0.4; 95% CI: 0.2–0.7). Conclusion: This study unveils self-reported Black race, young age (aged < 18 years) and Latinx ethnicity as potential risk factors associated with worse kidney outcomes.
ISSN:2468-0249

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