Pediatric patients with primary glomerular diseases may experience faster kidney function decline

New research reveals that contrary toconventional belief, primary glomerular diseases are not necessarily benign for children and young adults. In fact, some subsets of children and young adults may experience faster kidney function decline than older patients. The findings will be presented at ASN Kidney Week 2025 November 5–9.

Direct comparisons of outcomes between adult and pediatric patients with primary glomerular diseases are rare-including minimal change disease (MCD), focalsegmental 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 thesteepest declines in eGFR among their diagnosis cohorts. 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."

Margaret Helmuth, MS, lead author 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.

Study: "Glomerular Disease Outcomes Across the Lifespan: Report of the Cure Glomerulonephropathy (CureGN) Research Consortium"