Young patients with primary glomerular diseases need close monitoring and tailored care, research to be presented at ASN 2025.
Contrary to conventional wisdom, primary glomerular diseases may not always be benign in children and young adults. ()
Recent research indicates that certain subsets of younger patients could experience a more rapid decline in kidney function compared to older adults, challenging long-held assumptions about the progression of these conditions.
These findings highlight the urgent need for careful monitoring and tailored treatment strategies for younger populations affected by primary glomerular diseases.
The research will be formally presented at ASN Kidney Week 2025, taking place from November 5–9, where experts in nephrology will discuss its implications for clinical practice and long-term patient outcomes.
Urgent Need for Tailored Care in Young Patients with Glomerular Diseases
Direct comparisons of outcomes between adult and pediatric patients with primary glomerular diseases are rare—including minimal change disease (MCD), focal segmental glomerulosclerosis (FSGS), membranous nephropathy (MN), and IgA nephropathy (IgAN). Researchers analyzed data from CureGN, one of the largest longitudinal cohort studies of glomerular diseases.
When they examined the rate of kidney function decline and the risk of progression to the composite outcome of kidney failure, ≥40% drop in estimated glomerular filtration rate (eGFR), or death, children and young adults had similar or even higher risks of meeting these adverse outcomes as older adults.
Pediatric patients with a biopsy-diagnosis of MCD had steeper eGFR declines compared with adult patients with MCD. MN patients aged 13–17 years and FSGS and IgA nephropathy patients aged 18–44 years at the time of biopsy had the steepest declines in eGFR among their diagnosis cohorts.
Age Differences in Disease Progression Vary Across Glomerular Conditions
For patients with MCD, FSGS, and MN, no differences were detected among various age groups in the risk of progression to the composite outcome of death, kidney failure, or ≥40% eGFR decline, while IgA nephropathy patients aged 6–12 years, 13–17 years, and 45–64 years had lower risks of progression compared with those aged 18–44 years.
“These findings suggest that young patients who obtained a kidney biopsy diagnosis of primary glomerular disease face significant risk of reaching kidney failure and requiring dialysis and/or a transplant in their lifetimes. We believe that future studies are needed to shed light on the lifetime burden and morbidity of primary glomerular diseases on patients diagnosed at a young age,” said lead author Margaret Helmuth, MS, of the University of Michigan, Ann Arbor.
“Our research also highlights the importance of including children in clinical trials for disease treatment to mitigate against the adverse outcomes they face,” added co-author Chia-shi Wang, MD, MSc, of the Emory University School of Medicine.
References:
- Kidney Week – (https://www.asn-online.org/education/kidneyweek/2025/program-session-details.aspx?sessId=519874)
Source-Eurekalert