Outcomes Examined for Primary Nephrotic Syndrome in Adults
Significant variation observed for risk for developing end-stage kidney disease according to etiology of nephrotic syndrome
MONDAY, June 21, 2021 (HealthDay News) -- Adults with primary nephrotic syndrome (NS) experience higher adjusted rates of end-stage kidney disease (ESKD), cardiovascular outcomes, and death, according to a study published online June 18 in the Journal of the American Society of Nephrology.
Alan Go, M.D., from Kaiser Permanente of Northern California in Oakland, and colleagues evaluated kidney, cardiovascular, and mortality outcomes in adults with primary NS. The analysis was based on data from 907 cases of primary NS (655 definite and 252 presumed cases of focal segmental glomerulosclerosis [FSGS], membranous nephropathy, and minimal change disease), along with 89,593 matched adults without diabetes or known proteinuria (controls).
The researchers found that compared with controls, adults with primary NS had higher adjusted rates of ESKD (adjusted hazard ratio [aHR], 19.63), acute coronary syndrome (aHR, 2.58), heart failure (aHR, 3.01), ischemic stroke (aHR, 1.80), venous thromboembolism (aHR, 2.56), and death (aHR, 1.34). Compared with presumed minimal change disease, excess ESKD risk was significantly higher for FSGS and membranous nephropathy. For cardiovascular outcomes and death, the investigators observed no significant differences in risk based on the etiology of primary NS.
"Our study also points to the need for patients with primary nephrotic syndrome to be identified as early as possible so that they can begin to implement lifestyle changes -- such as moving toward a healthy diet, stopping smoking, getting more exercise -- and to be evaluated for preventive therapies that can reduce their risk for both cardiovascular disease and kidney failure," Go said in a statement.
One author disclosed financial ties to the pharmaceutical industry.