Kidney Week

Abstract: SA-OR72

Major Adverse Cardiovascular Events (MACE) in Proteinuric Glomerulopathies: A CureGN and NEPTUNE Study

Session Information

• Glomerular Diseases: Clinical Advances
  October 26, 2024 | Location: Room 6D, Convention Center
  Abstract Time: 05:50 PM - 06:00 PM

Category: Glomerular Diseases

• 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics

Authors

• Schuchman, Matthew, Northwell Health, New Hyde Park, New York, United States

Matthew Schuchman

• Sethna, Christine B., Northwell Health, New Hyde Park, New York, United States

Christine B. Sethna, MD, MEd

• Smith, Abigail R., Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States

Abigail R. Smith, PhD

• Gadegbeku, Crystal A., Cleveland Clinic, Cleveland, Ohio, United States

Crystal A. Gadegbeku, MD, FASN

• Glenn, Dorey A., The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States

Dorey A. Glenn, MD, MPH

• Waldman, Meryl, National Institutes of Health, Bethesda, Maryland, United States

Meryl Waldman, MD

• Nachman, Patrick H., University of Minnesota Twin Cities, Minneapolis, Minnesota, United States

Patrick H. Nachman, MD, FASN

• Kerlin, Bryce A., Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, United States

Bryce A. Kerlin, MD

• Robinson, Bruce M., University of Michigan Michigan Medicine, Ann Arbor, Michigan, United States

Bruce M. Robinson, MD, MS, FASN

• Alakwaa, Fadhl, University of Michigan Michigan Medicine, Ann Arbor, Michigan, United States

Fadhl Alakwaa, PhD

• Adler, Sharon G., Harbor-UCLA Medical Center, Torrance, California, United States

Sharon G. Adler, MD, FASN

• Gonzalez-Vicente, Agustin, Case Western Reserve University, Cleveland, Ohio, United States

Agustin Gonzalez-Vicente, PhD

• Bitzer, Markus, University of Michigan Michigan Medicine, Ann Arbor, Michigan, United States

Markus Bitzer, MD

• Srivastava, Tarak, Children's Mercy Kansas City, Kansas City, Missouri, United States

Tarak Srivastava, MD, FASN

• Khalid, Myda, Indiana University, Bloomington, Indiana, United States

Myda Khalid, MD

• Derebail, Vimal K., University of North Carolina Chapel Hill, Chapel Hill, North Carolina, United States

Vimal K. Derebail, MD, MPH, FASN

• Hall, Gentzon, Duke Health, Durham, North Carolina, United States

Gentzon Hall, MD, PhD, FASN

• Tuttle, Katherine R., Providence St Joseph Health, Renton, Washington, United States

Katherine R. Tuttle, MD, FASN

• O'Shaughnessy, Michelle M., University College Cork, Cork, Cork, Ireland

Michelle M. O'Shaughnessy, MD, MBChB, MS, FASN

• Cara-Fuentes, Gabriel M., Nationwide Children's Hospital, Columbus, Ohio, United States

Gabriel M. Cara-Fuentes, MD, PhD

• Roehm, Bethany Angela, The University of Texas Southwestern Medical Center, Dallas, Texas, United States

Bethany Angela Roehm, MD, MS

• Zee, Jarcy, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States

Jarcy Zee, PhD

• Gomez, Alexis C., Boston Children's Hospital, Boston, Massachusetts, United States

Alexis C. Gomez, MD

• Trachtman, Howard, University of Michigan Michigan Medicine, Ann Arbor, Michigan, United States

Howard Trachtman, MD, FASN

• Mathew, Roy O., VA Loma Linda Healthcare System, Loma Linda, California, United States

Roy O. Mathew, MD, FASN

Group or Team Name

• On behalf of the NEPTUNE Cardiovascular Working Group.

Background

Relationships between clinical characteristics and MACE have not been well characterized in patients with proteinuric glomerulopathies.

Methods

Participants in NEPTUNE and CureGN (N=3224) with biopsy-proven minimal change disease, focal segmental glomerulosclerosis, membranous nephropathy or IgA nephropathy/vasculitis were included. The primary outcome was time from enrollment to MACE (first heart failure, stroke, or coronary artery disease event). Crude Cox regressions (Table) identified clinical characteristics with p<0.2 for inclusion in multivariable Cox regression using backwards selection to find best fit for final model. Age, sex, obesity and days from biopsy were forced into the model a priori .

Results

Mean age was 33.3±21.5 yrs, 35% <18 yrs, median follow-up 55 months. 158 total events in 134 (4.2%) participants were recorded: 39 stroke, 47 heart failure, and 72 coronary artery disease. In multivariable modeling, older age (HR 1.04, CI 1.03-1.06 p<0.001), obesity (HR 1.56, CI 1.07-2.3 p=0.02), prior history of MACE (HR 11.46, CI 7.33-17.92, p<0.001) and chronic kidney disease (CKD) stage 5 (HR 4.41, 1.45-13.44, p<0.01) at enrollment were associated with MACE.

Conclusion

Surprisingly, proteinuria and glomerulopathies were not associated with MACE, but risk factors identified in other CKD cohorts retain importance. Further analyses will characterize additional non-traditional predictors of cardovascular disease.

Funding

• NIDDK Support