Association of kidney failure risk equation with pathological features

 

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Association of kidney failure risk equation with pathological features

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Sylvia
Rosas
Sylvia Rosas sylvia.rosas@joslin.harvard.edu Joslin Diabetes Center Nephrology Boston United States *
Stewart Lecker slecker@bidmc.harvard.edu Beth Israel Deaconess Medical Center Nephrology Boston United States -
Alexander Morales amorale7@bidmc.harvard.edu Beth Israel Deaconess Medical Center Nephrology Boston United States -
 
 
 
 
 
 
 
 
 
 
 
 

Risk equations to predict kidney failure have been developed allowing clinicians to intensify therapy in high-risk groups. However, it is unknown if these risk categories are associated with pathological features. The kidney failure risk equation (KFRE) uses age, sex, GFR, and urine albumin-to-creatinine ratio (ACR) to predict 2-year risk of kidney failure. 

We evaluated if kidney pathological features were associated with the KFRE categories in the Kidney Precision Medicine Project (KPMP) in 266 individuals with chronic kidney disease and GFR<60 ml/min/1.73m2.   We used chi square test for categorical variables and anova for continous variables.

Participants were 46% female, 37% African American, 44% White and 25.5% Latino with an average age of 57.5 (13.1) years. Given the inclusion criteria for KPMP, the majority of participants were in the moderate (60.2%) and high-risk category (33.1%).  The majority of individuals entered the study based on the diabetes kidney disease (71.3%) criteria and an additional 28.7% based on hypertension criteria. In individuals with diabetes, there was no association between the diabetes glomerulopathy stages and KFRE risk categories. The distribution of absent, mild-mod and severe arteriosclerosis was similar across KFRE categories. In the severe KFRE category, 3.3% had no arteriosclerosis, 61.7% had mild-mod and 35% severe arteriosclerosis. Eosinophils were more likely to be present in mild category (22.2%) compared to severe category (14%). Higher fibrosis (2-3+) was more common in the high-risk KFRE category (57.6%) but was not significantly different from mild (55.6%) and moderate (49.1%) KFRE category. Hyalinosis was absent in 22.2% of individuals with mild risk compared to 21.2% in moderate risk and 13.6% in severe risk.


There are no significant pathological differences identified by KFRE categories in individuals in KPMP. In the future, we will evaluate the molecular signatures of each KFRE categories.

Kewords