Longitudinal change in proteinuria and kidney outcomes in C3 glomerulopathy
Por:
Caravaca-Fontan, F, Diaz-Encarnacion, M, Cabello, V, Ariceta, G, Quintana, LF, Marco, H, Barros, X, Ramos, N, Rodriguez-Mendiola, N, Cruz, S, Fernandez-Juarez, G, Rodriguez, A, de Jose, AP, Rabasco, C, Rodado, R, Fernandez, L, Gomez, VP, Avila, A, Bravo, L, Espinosa, N, Allende, N, de la Nieta, MDS, Rodriguez, E, Olea, T, Melgosa, M, Huerta, A, Miquel, R, Mon, C, Fraga, G, de Lorenzo, A, Draibe, J, Cano-Megias, M, Gonzalez, F, Shabaka, A, Lopez-Rubio, ME, Fenollosa, MA, Martin-Penagos, L, Da Silva, I, Titos, JA, de Cordoba, SR, de Jorge, EG and Praga, M
Publicada:
23 jun 2022
Resumen:
Introduction The association between a change in proteinuria over time and its impact on kidney prognosis has not been analysed in complement component 3 (C3) glomerulopathy. This study aims to investigate the association between the longitudinal change in proteinuria and the risk of kidney failure. Methods This was a retrospective, multicentre observational cohort study in 35 nephrology departments belonging to the Spanish Group for the Study of Glomerular Diseases. Patients diagnosed with C3 glomerulopathy between 1995 and 2020 were enrolled. A joint modelling of linear mixed-effects models was applied to assess the underlying trajectory of a repeatedly measured proteinuria, and a Cox model to evaluate the association of this trajectory with the risk of kidney failure. Results The study group consisted of 85 patients, 70 C3 glomerulonephritis and 15 dense deposit disease, with a median age of 26 years (range 13-41). During a median follow-up of 42 months, 25 patients reached kidney failure. The longitudinal change in proteinuria showed a strong association with the risk of this outcome, with a doubling of proteinuria levels resulting in a 2.5-fold increase of the risk. A second model showed that a >= 50% proteinuria reduction over time was significantly associated with a lower risk of kidney failure (hazard ratio 0.79; 95% confidence interval 0.56-0.97; P < 0.001). This association was also found when the >= 50% proteinuria reduction was observed within the first 6 and 12 months of follow-up. Conclusions The longitudinal change in proteinuria is strongly associated with the risk of kidney failure. The change in proteinuria over time can provide clinicians a dynamic prediction of kidney outcomes.
Filiaciones:
Caravaca-Fontan, F:
Hosp 12 de Octubre, Inst Invest Hosp, Madrid, Spain
Univ Complutense Madrid, Dept Med, Madrid, Spain
Diaz-Encarnacion, M:
Fdn Puigvert, Dept Nephrol, Barcelona, Spain
Cabello, V:
Hosp Univ Virgen Rocio, Dept Nephrol, Seville, Spain
Ariceta, G:
Univ Autonoma Barcelona, Hosp Univ Vall Hebron, Dept Pediat Nephrol, Barcelona, Spain
Quintana, LF:
Hosp Clin Barcelona, Dept Nephrol & Renal Transplantat, Barcelona, Spain
Univ Barcelona, Dept Med, IDIBAPS, Barcelona, Spain
:
Hosp Badalona Germans Trias & Pujol, Dept Nephrol, Barcelona, Spain
Barros, X:
Hosp Univ Doctor Josep Trueta, Dept Nephrol, Girona, Spain
Ramos, N:
Hosp Univ Vall dHebron, Dept Nephrol, Barcelona, Spain
Rodriguez-Mendiola, N:
Hosp Univ Ramon & Cajal, Dept Nephrol, Madrid, Spain
Cruz, S:
Hosp Univ Juan Ramon Jimenez, Dept Nephrol, Huelva, Spain
Fernandez-Juarez, G:
Hosp Univ Fundac Alcorcon, Dept Nephrol, Madrid, Spain
Rodriguez, A:
Hosp Univ Virgen Rocio, Dept Pediat Nephrol, Seville, Spain
de Jose, AP:
Hosp Univ Gregorio Maranon, Dept Nephrol, Madrid, Spain
Rabasco, C:
Hosp Univ Reina Sofia, Dept Nephrol, Cordoba, Spain
Rodado, R:
Hosp Univ Virgen Arrixaca, Dept Nephrol, Murcia, Spain
Fernandez, L:
Complejo Hosp Navarra, Dept Nephrol, Navarra, Spain
Gomez, VP:
Hosp Univ Fundac Jimenez Diaz, Dept Nephrol, Madrid, Spain
Avila, A:
Hosp Univ Doctor Peset, Dept Nephrol, Valencia, Spain
Bravo, L:
Hosp Univ A Coruna, Dept Nephrol, La Coruna, Spain
Espinosa, N:
Hosp Univ Son Espases, Balear Islands Hlth Res Inst IdISBa, Pediat Nephrol Unit, Palma de Mallorca, Spain
Allende, N:
Hosp Univ Son Espases, Dept Nephrol, Palma De Mallorca, Spain
de la Nieta, MDS:
Hosp Gen Univ Ciudad Real, Dept Nephrol, Ciudad Real, Spain
Rodriguez, E:
Hosp del Mar, Dept Nephrol, Barcelona, Spain
Olea, T:
Hosp Univ La Paz, Dept Nephrol, Madrid, Spain
Melgosa, M:
Hosp Univ La Paz, Dept Pediat Nephrol, Madrid, Spain
Huerta, A:
Hosp Univ Puerta Hierro, Dept Nephrol, Madrid, Spain
Miquel, R:
Hosp Univ Canarias, Dept Nephrol, Tenerife, Spain
Mon, C:
Hosp Univ Severo Ochoa, Dept Nephrol, Madrid, Spain
Fraga, G:
Univ Autonoma Barcelona, Hosp Santa Creu & Sant Pau, Dept Pediat Nephrol, Barcelona, Spain
de Lorenzo, A:
Hosp Univ Getafe, Dept Nephrol, Madrid, Spain
Draibe, J:
Hosp Univ Bellvitge, Dept Nephrol, Barcelona, Spain
Cano-Megias, M:
Hosp Univ Principe De Asturias, Dept Nephrol, Madrid, Spain
Gonzalez, F:
Hosp Doctor Negrin, Dept Nephrol, Gran Canaria, Spain
Shabaka, A:
Hosp Univ Clin San Carlos, Dept Nephrol, Madrid, Spain
Lopez-Rubio, ME:
Complejo Hosp Univ Albacete, Dept Nephrol, Albacete, Spain
Fenollosa, MA:
Hosp Gen Univ Castellon, Dept Nephrol, Castellon de La Plana, Spain
Martin-Penagos, L:
Hosp Univ Marques Valdecilla, Dept Nephrol, Santander, Spain
Titos, JA:
Hosp Reg Univ Carlos Haya, Dept Nephrol, Malaga, Spain
de Cordoba, SR:
CSIC, Ctr Invest Biol, Madrid, Spain
Ctr Invest Biomed Red Enfermed Raras, Madrid, Spain
de Jorge, EG:
Hosp 12 de Octubre, Inst Invest Hosp, Madrid, Spain
Univ Complutense Madrid, Dept Immunol, Madrid, Spain
Praga, M:
Hosp 12 de Octubre, Inst Invest Hosp, Madrid, Spain
Univ Complutense Madrid, Dept Med, Madrid, Spain
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