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Título: | Longitudinal change in proteinuria and kidney outcomes in C3 glomerulopathy |
Autor: | Caravaca-Fontán, Fernando; Díaz-Encarnación, Montserrat M.; Cabello, Virginia; Ariceta, Gema; Quintana, Luis F.; Marco, Helena; Barros, Xoana; Ramos, Natalia; Rodríguez-Mendiola, Nuria; Cruz, Sonia; Fernández-Juárez, Gema; Rodríguez, Adela; Pérez de José, Ana; Rabasco, Cristina; Rodado, Raquel; Fernández, Loreto; Pérez Gómez, Vanessa; Ávila, Ana; Bravo, Luis; Espinosa, Natalia; Allende, Natalia; Sánchez de la Nieta, María Dolores; Rodríguez, Eva; Olea, Teresa; Melgosa, Marta; Huerta, Ana; Miquel, Rosa; Mon, Carmen; Fraga, Gloria; de Lorenzo, Alberto; Draibe, Juliana; Cano-Megías, Marta; González, Fayna; Shabaka, Amir; López-Rubio, María Esperanza; Fenollosa, María Ángeles; Martín-Penagos, L.; Da Silva, Iara; Alonso Titos, Juana; Rodríguez de Córdoba, Santiago ; Goicoechea de Jorge, Elena CSIC ORCID; Praga, Manuel; Spanish Group for the Study of Glomerular Diseases (GLOSEN) | Palabras clave: | C3 glomerulopathy Joint models Kidney failure Proteinuria |
Fecha de publicación: | 29-mar-2021 | Editor: | Oxford University Press | Citación: | Nephrology Dialysis Transplantation gfab075 (2021) | Resumen: | Introduction: The association between a change in proteinuria over time and its impact in kidney prognosis has not been analyzed in C3 glomerulopathy. This study aims to investigate the association between the longitudinal change in proteinuria and the risk of kidney failure. Methods: Retrospective, multicenter observational cohort study in 35 nephrology departments belonging to the Spanish Group for the Study of Glomerular Diseases (GLOSEN). Patients diagnosed with C3 glomerulopathy between 1995 and 2020 were enrolled. A joint modeling 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 (HR: 0.79; 95% CI : 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. Conclusion: 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. |
Descripción: | 11 p.-4 fig.-4 tab. | Versión del editor: | https://doi.org/10.1093/ndt/gfab075 | URI: | http://hdl.handle.net/10261/265019 | DOI: | 10.1093/ndt/gfab075 | ISSN: | 0931-0509 | E-ISSN: | 1460-2385 |
Aparece en las colecciones: | (CIB) Artículos |
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