Journal Article

DKFZ-2021-00452

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Quantifying Duration of Proteinuria Remission and Association with Clinical Outcome in IgA Nephropathy.

Canney, M. ; Barbour, S. J. ; Zheng, Y. ; Coppo, R. ; Zhang, H. ; Liu, Z.-H. ; Matsuzaki, K. ; Suzuki, Y. ; Katafuchi, R. ; Reich, H. N. ; Cattran, D. ; Network, I. I. N. (Collaboration Author) ; Investigators, I. I. N. N. (Collaboration Author) ; Russo, M. L. ; Troyanov, S. ; Cook, H. T. ; Roberts, I. ; Tesar, V. ; Maixnerova, D. ; Lundberg, S. ; Emma, F. ; Fuiano, L. ; Beltrame, G. ; Rollino, C. ; Amore, A. ; Camilla, R. ; Peruzzi, L. ; Praga, M. ; Feriozzi, S. ; Polci, R. ; Segoloni, G. ; Colla, L. ; Pani, A. ; Piras, D. ; Angioi, A. ; Cancarini, G. ; Ravera, S. ; Durlik, M. ; Moggia, E. ; Ballarin, J. ; Di Giulio, S. ; Pugliese, F. ; Serriello, I. ; Caliskan, Y. ; Sever, M. ; Kilicaslan, I. ; Locatelli, F. ; Del Vecchio, L. ; Wetzels, J. F. M. ; Peters, H. ; Berg, U. ; Carvalho, F. ; da Costa Ferreira, A. C. ; Maggio, M. ; Wiecek, A. ; Ots-Rosenberg, M. ; Magistroni, R. ; Topaloglu, R. ; Bilginer, Y. ; D'Amico, M. ; Stangou, M. ; Giacchino, F. ; Goumenos, D. ; Kalliakmani, P. ; Gerolymos, M. ; Galesic, K. ; Geddes, C. ; Siamopoulos, K. ; Balafa, O. ; Galliani, M. ; Stratta, P. ; Quaglia, M. ; Bergia, R. ; Cravero, R. ; Salvadori, M. ; Cirami, L. ; Fellstrom, B. ; Smerud, H. K. ; Ferrario, F. ; Stellato, T. ; Egido, J. ; Martin, C. ; Floege, J. ; Eitner, F. ; Lupo, A. ; Bernich, P. ; Menè, P. ; Morosetti, M. ; van Kooten, C. ; Rabelink, T. ; Reinders, M. E. J. ; Grinyo, J. M. B. ; Cusinato, S. ; Benozzi, L. ; Savoldi, S. ; Licata, C. ; Mizerska-Wasiak, M. ; Martina, G. ; Messuerotti, A. ; Dal Canton, A. ; Esposito, C. ; Migotto, C. ; Triolo, G. ; Mariano, F. ; Pozzi, C. ; Boero, R. ; Bellur, S. ; Mazzucco, G. ; Giannakakis, C. ; Honsova, E. ; Sundelin, B. ; Di Palma, A. M. ; Ferrario, F. ; Gutiérrez, E. ; Asunis, A. M. ; Barratt, J. ; Tardanico, R. ; Perkowska-Ptasinska, A. ; Terroba, J. A. ; Fortunato, M. ; Pantzaki, A. ; Ozluk, Y. ; Steenbergen, E. ; Soderberg, M. ; Riispere, Z. ; Furci, L. ; Orhan, D. ; Kipgen, D. ; Casartelli, D. ; Ljubanovic, D. G. ; Gakiopoulou, H. ; Bertoni, E. ; Ortiz, P. C. ; Karkoszka, H. ; Groene, H. J. ; Stoppacciaro, A. ; Bajema, I. ; Bruijn, J. ; Oliveras, X. F. ; Maldyk, J. ; Ioachim, E. ; Bavbek, N. ; Cook, T. ; Troyanov, S. ; Alpers, C. ; Amore, A. ; Barratt, J. ; Feehally, J. ; Berthoux, F. ; Bonsib, S. ; Bruijn, J. ; D'Agati, V. ; D'Amico, G. ; Emancipator, S. ; Emmal, F. ; Ferrario, F. ; Fervenza, F. ; Florquin, S. ; Fogo, A. ; Geddes, C. ; Groene, H.DKFZ* ; Haas, M. ; Hill, P. ; Hogg, R. ; Hsu, S. ; Hunley, T. ; Hladunewich, M. ; Jennette, C. ; Joh, K. ; Julian, B. ; Kawamura, T. ; Lai, F. ; Leung, C. ; Li, L. ; Li, P. ; Liu, Z. ; Massat, A. ; Mackinnon, B. ; Mezzano, S. ; Schena, F. ; Tomino, Y. ; Walker, P. ; Wang, H. ; Weening, J. ; Yoshikawa, N. ; Zeng, C.-H. ; Shi, S. ; Suzuki, H. ; Koike, K. ; Hirano, K. ; Kawamura, T. ; Yokoo, T. ; Hanai, M. ; Fukami, K. ; Takahashi, K. ; Yuzawa, Y. ; Niwa, M. ; Yasuda, Y. ; Maruyama, S. ; Ichikawa, D. ; Suzuki, T. ; Shirai, S. ; Fukuda, A. ; Fujimoto, S. ; Trimarchi, H.

2021
Ovid [S.l.]

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Please use a persistent id in citations: doi:10.1681/ASN.2020030349

Abstract: On the basis of findings of observational studies and a meta-analysis, proteinuria reduction has been proposed as a surrogate outcome in IgA nephropathy. How long a reduction in proteinuria needs to be maintained to mitigate the long-term risk of disease progression is unknown.In this retrospective multiethnic cohort of adult patients with IgA nephropathy, we defined proteinuria remission as a ≥25% reduction in proteinuria from the peak value after biopsy, and an absolute reduction in proteinuria to <1 g/d. The exposure of interest was the total duration of first remission, treated as a time-varying covariate using longitudinal proteinuria measurements. We used time-dependent Cox proportional hazards regression models to quantify the association between the duration of remission and the primary outcome (ESKD or a 50% reduction in eGFR).During a median follow-up of 3.9 years, 274 of 1864 patients (14.7%) experienced the primary outcome. The relationship between duration of proteinuria remission and outcome was nonlinear. Each 3 months in sustained remission up to approximately 4 years was associated with an additional 9% reduction in the risk of disease progression (hazard ratio [HR], 0.91; 95% confidence interval [95% CI], 0.89 to 0.93). Thereafter, each additional 3 months in remission was associated with a smaller, nonsignificant risk reduction (HR, 0.99; 95% CI, 0.96 to 1.03). These findings were robust to multivariable adjustment and consistent across clinical and histologic subgroups.Our findings support the use of proteinuria as a surrogate outcome in IgA nephropathy, but additionally demonstrate the value of quantifying the duration of proteinuria remission when estimating the risk of hard clinical endpoints.

Keyword(s): IgA nephropathy ; end stage kidney disease ; epidemiology and outcomes ; glomerular disease ; proteinuria ; renal function decline ; renal pathology

Note: Groene H (MD, Department of Cellular and Molecular Pathology, German Cancer Research Center, Heidelberg, Germany)

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Contributing Institute(s):

1. Zelluläre und Molekulare Pathologie (G130)

Research Program(s):

1. 311 - Zellbiologie und Tumorbiologie (POF4-311) (POF4-311)

Appears in the scientific report 2021

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; BIOSIS Previews ; Biological Abstracts ; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; Current Contents - Life Sciences ; Essential Science Indicators ; IF >= 5 ; JCR ; PubMed Central ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

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