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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
Proteinuria has recently been proposed as an early surrogate endpoint of long-term kidney outcomes in clinical trials. However, seasonal fluctuations in proteinuria (higher in winter and lower in summer) may obscure the true effect of interventions on proteinuria. This study aimed to elucidate how the season at the initiation of intervention modifies the association between early changes in proteinuria after intervention and kidney outcomes.
We retrospectively extracted data on 1,440 patients from the Osaka Consortium for Kidney Disease Research (OCKR) cohort, who initiated renin–angiotensin system inhibitors (RASi) during the Summer or Winter and had a urinary protein-to-creatinine ratio (UPCR) of ≥0.50 g/gCr before initiation of RASi. A mixed-effects model for repeated measures was applied to evaluate early changes in UPCR after RASi initiation according to the season of RASi initiation. Cox proportional hazards models were used to examine how the season of RASi initiation modifies associations between UPCR changes at 6, 9, or 12 months after RASi initiation and the subsequent risk of kidney replacement therapy (KRT).
Baseline characteristics and the risk of KRT were similar between Summer- and Winter-season initiators. Nevertheless, the mean percent reduction in UPCR at 6 months after RASi initiation was substantially greater in the Winter-season initiators than in the Summer-season initiators (59% [95% confidence interval (CI), 56-61] vs 37% [95% CI, 31-41]; between-group difference 22% [95% CI, 17-27]; P<0.001). The between-group difference was attenuated at 9 and 12 months (3.5% [95% CI, -1.1 to 8.9] at 9 months; 10% [95% CI, 6.3-15] at 12 months). A ≥30% reduction in UPCR at 6 months was associated with an 18% lower hazard of KRT (HR, 0.82; 95% CI, 0.75–0.91) in the Summer-season initiators, compared with a non-significant 6% reduction (HR, 0.94; 95% CI, 0.87–1.01) in the Winter-season initiators (P for interaction=0.02). In contrast, a ≥30% reduction in UPCR at 9 and 12 months was associated with comparable hazards of KRT in the Summer- and Winter-season initiators (P for interaction= 0.24 and 0.71).
UPCR reduction at 6 months after intervention was considerably affected by seasonal fluctuations. UPCR changes at 9 or 12 months may serve as a more reliable surrogate marker for long-term kidney outcomes.
