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Abstract: TH-PO613

Role of Neighborhood Disadvantage in Patient Outcomes in Childhood Nephrotic Syndrome in the CureGN Cohort

Session Information

Category: Glomerular Diseases

  • 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics

Authors

  • Onugha, Elizabeth Anyaegbu, Baylor College of Medicine, Houston, Texas, United States
  • Smith, Abigail R., Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
  • Helmuth, Margaret, University of Michigan, Ann Arbor, Michigan, United States
  • Krissberg, Jill, Ann & Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois, United States
  • Massengill, Susan F., Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States
  • Wang, Chia- Shi, Emory University, Atlanta, Georgia, United States
  • Brakeman, Paul R., University of California San Francisco, San Francisco, California, United States
  • Parekh, Rulan S., Women's College Hospital, Toronto, Ontario, Canada
  • Hingorani, Sangeeta R., Seattle Children's Hospital, Seattle, Washington, United States
Background

Disparities in clinical outcomes in childhood nephrotic syndrome are not completely explained by race and genetics. We aim to examine the influence of residential neighborhood on disease activity and progression in childhood nephrotic syndrome using the Child Opportunity Index (COI).

Methods

CureGN is a prospective cohort study of patients with glomerular diseases diagnosed by biopsy within 5 years prior to enrollment. CureGN pediatric participants with minimal change disease (MCD) and focal segmental glomerulosclerosis (FSGS) with census tract data were included. COI composite score and subdomain scores in education, health and environment, and social and economic were categorized into quintiles and examined for associations with development of ESKD or 40% decline in eGFR using Kaplan-Meier estimates and log-rank tests.

Results

371 children (228 MCD; 143 FSGS) with a median follow-up of 5.8 years (IQR 3.4-7.2) were included. Median age at biopsy was 8 years (IQR 4-7); 58% were White, 26% Black, and 12% Hispanic. In the subset of children with FSGS, the probability of progression to kidney failure or 40% decline differed across quintiles of the education domain COI (p=0.02).

Conclusion

In a national cohort of children with nephrotic syndrome, children with FSGS who resided in areas with lower education opportunities had a higher probability of disease progression. Future work will assess potential ways to mitigate the effects of neighborhood opportunities on outcomes.

Time to composite endpoint by COI levels (FSGS only)

Funding

  • NIDDK Support