Kidney Week

Abstract: FR-PO850

Cardiorenal Outcomes in Patients with IgAN: The FinnGen Study

Session Information

• IgA Nephropathy: Clinical, Outcomes, and Therapeutics
  October 25, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Glomerular Diseases

• 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics

Authors

• Visser, Tomas Juhani, Helsingin Yliopisto Laaketieteellinen Tiedekunta, Helsinki, Finland

Tomas Juhani Visser

• Pyle, Laura, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States

Laura Pyle, PhD

• Narongkiatikhun, Phoom, Chiang Mai University, Chiang Mai, Thailand

Phoom Narongkiatikhun, MD

• Choi, Ye Ji, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States

Ye Ji Choi, MPH

• Cherney, David, Toronto General Hospital, Toronto, Ontario, Canada

David Cherney, MD, PhD

• Rodosthenous, Rodosthenis S., Helsingin Yliopisto Suomen Molekyylilaaketieteen Instituutti, Helsinki, Finland

Rodosthenis S. Rodosthenous, ScD

• Kiryluk, Krzysztof, Columbia University, New York, New York, United States

Krzysztof Kiryluk, MD

• Bjornstad, Petter, University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, United States

Petter Bjornstad, MD

• Niiranen, Teemu, Turun Yliopisto Laaketieteellinen Tiedekunta, Turku, Finland

Teemu Niiranen, MD

• Finne, Patrik, Helsingin Seudun Yliopistollinen Keskussairaala, Helsinki, Finland

Patrik Finne, MD, PhD

• Gordin, Daniel, Helsingin Seudun Yliopistollinen Keskussairaala, Helsinki, Finland

Daniel Gordin, MD, PhD

Group or Team Name

• FinnGen.

Background

Long-term cardiorenal outcomes of Immunoglobulin A Nephropathy (IgAN) are incompletely understood. We assessed kidney function and cardiorenal events in patients with IgAN in the FinnGen study, which covers approximately 10% of the Finnish population (N=520210).

Methods

Patients with IgAN were identified using Finnish ICD10 diagnosis codes. The outcomes of interest were annual estimated glomerular filtration rate (eGFR) decline, start of kidney replacement therapy (KRT), and major adverse cardiovascular events (MACE). Out of 889 patients with IgAN, 265 were selected based on available data for eGFR. We compared outcomes in patients with IgAN (cases) vs. those with diabetes (controls), being the most common group requiring KRT in Finland. Cases (n=265) and controls (n=1060) were matched by eGFR, age, sex, and birth year (ratio 1:4). Multivariable-adjusted Cox regression and mixed-effects models were used to compare the groups.

Results

Annual eGFR decline was more rapid in patients with IgAN (-2.26; 95% Confidence Interval [95% CI] -2.33, -2.18 ml/min/1.73 m² per year) compared to those with diabetes (-1.28; 95% CI -1.43, -1.12 ml/min/1.73 m² per year). The cumulative incidence of KRT and MACE in patiens with IgAN and diabetes is shown in Figure 1. The risk for KRT was higher in individuals with IgAN compared to those with diabetes (Hazard Ratio [HR] 4.63; 95% CI 3.49, 6.16). However, the risk for MACE was lower in patients with IgAN (HR 0.61; 95% CI 0.47, 0.88) compared to patients with diabetes.

Conclusion

In this large register study, we demonstrated that patients with IgAN had a faster decline in eGFR and greater risk for KRT compared to patients with diabetes. In contrast, risk for MACE was lower in IgAN compared to diabetes in long-term follow-up.

Figure 1: Cumulative incidence of major adverse cardiovascular events (MACE) and kidney replacement therapy (KRT) from diagnosis in patients with IgA nephropathy and diabetes.

Funding

• Private Foundation Support