End-Stage Renal Disease and Mortality Outcomes Across Different Glomerulonephropathies in a Large Diverse US Population

To compare renal function decline, incident end-stage renal disease (ESRD), and mortality among patients with 5 common glomerular diseases in a large diverse population. A retrospective cohort study (between January 1, 2000, and December 31, 2011) of patients with glomerulonephropathy using the elec...

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Bibliographic Details
Published in:Mayo Clinic proceedings 2018-02, Vol.93 (2), p.167-178
Main Authors: Sim, John J., Bhandari, Simran K., Batech, Michael, Hever, Aviv, Harrison, Teresa N., Shu, Yu-Hsiang, Kujubu, Dean A., Jonelis, Tracy Y., Kanter, Michael H., Jacobsen, Steven J.
Format: Article
Language:English
Subjects:
Adult
Biopsy
Biopsy - methods
California - epidemiology
Care and treatment
Chronic kidney failure
Cohort Studies
Dialysis
Electronic records
End-stage renal disease
Ethnic Groups
Female
Glomerular Filtration Rate
Glomerulonephritis
Glomerulonephritis - classification
Glomerulonephritis - complications
Glomerulonephritis - mortality
Glomerulonephritis - physiopathology
Humans
Immunoglobulins
Incidence
Kidney diseases
Kidney Failure, Chronic - diagnosis
Kidney Failure, Chronic - epidemiology
Kidney Failure, Chronic - etiology
Kidney Glomerulus - pathology
Kidney Glomerulus - physiopathology
Lupus
Male
Middle Aged
Mortality
Patient Care Management - methods
Peritoneal dialysis
Population
Proportional Hazards Models
Risk Factors
Survival Analysis
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Summary:To compare renal function decline, incident end-stage renal disease (ESRD), and mortality among patients with 5 common glomerular diseases in a large diverse population. A retrospective cohort study (between January 1, 2000, and December 31, 2011) of patients with glomerulonephropathy using the electronic health record of an integrated health system was performed. Estimated glomerular filtration rate (eGFR) change, incident ESRD, and mortality were compared among patients with biopsy-proven focal segmental glomerulosclerosis (FSGS), membranous glomerulonephritis (MN), minimal change disease (MCD), immunoglobulin A nephropathy (IgAN), and lupus nephritis (LN). Competing risk models were used to estimate hazard ratios for different glomerulonephropathies for incident ESRD, with mortality as a competing outcome after adjusting for potential confounders. Of the 2350 patients with glomerulonephropathy (208 patients [9%] younger than 18 years) with a mean follow-up of 4.5±3.6 years, 497 (21%) progressed to ESRD and 195 (8%) died before ESRD. The median eGFR decline was 1.0 mL/min per 1.73 m2 per year but varied across different glomerulonephropathies (P
ISSN:0025-6196
1942-5546
DOI:10.1016/j.mayocp.2017.10.021