Glomerular Disease Progression Risk Consistent Across Ages, But Younger Patients Face Higher Lifetime Risk
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A new study reveals that patients with primary glomerular disease (GD) experience similar rates of kidney function decline regardless of age at diagnosis, though younger individuals are at a significantly elevated lifetime risk of kidney failure. The findings, presented November 7, 2025, at the American Society of Nephrology (ASN) Kidney Week in Houston, Texas, underscore the need for tailored monitoring adn potential treatment strategies for those diagnosed at a young age. Researchers from the Cure Glomerulonephropathy (curegn) Research Consortium analyzed data from 2,915 patients across North America and Europe.
Understanding Primary Glomerular Diseases
Primary glomerular diseases – including minimal change disease (MCD), focal segmental glomerulosclerosis (FSGS), membranous nephropathy (MN), and iga nephropathy (igan) – are leading causes of kidney failure globally. These conditions often necessitate lifelong medical management. “Direct comparisons of outcomes between adult and pediatric patients with primary glomerular disease are rare,” explained a study investigator from the University of Michigan, Ann Arbor.”We compared disease outcomes among patients with these conditions across the lifespan.”
The study addressed a critical gap in knowledge: how age at diagnosis impacts long-term disease trajectory. Understanding this relationship is crucial for refining follow-up protocols and identifying individuals most vulnerable to kidney failure.
Key Findings from the CureGN Consortium Study
Researchers followed participants for a median of 5.6 years, tracking the risk of death, end-stage kidney disease (ESKD), and a ≥40% decline in estimated glomerular filtration rate (eGFR) – a key measure of kidney function – to below 60ml/min/1.73m2. Age at biopsy served as the primary predictor in the analysis,which was adjusted for factors like sex,race/ethnicity,proteinuria,and initial eGFR levels.
The data revealed nuanced patterns.Pediatric patients with MCD exhibited steeper eGFR declines compared to adults. Specifically, eGFR declines ranged from -0.6 to -1.3 mL/min/1.73m2 in children versus -0.4 to 0.5 mL/min/1.73m2 in adults. Furthermore, individuals aged 13-17 with MN, and those aged 18-44 with FSGS and IgAN, experienced the most rapid eGFR declines within their respective diagnostic groups.
Interestingly, across MCD, FSGS, and MN, there were no meaningful differences in the risk of progression – defined as death, ESKD, or a substantial eGFR drop – between different age groups. However, patients with IgAN aged 6-12, 13-17, and 45-64 demonstrated lower risks of progression compared to those aged 18-44 (hazard ratios of 0.33, 0.44, and 0.64, respectively). `.
Implications for Patient Care and Future Research
“These findings suggest that young patients diagnosed with primary glomerular disease face a substantial risk of ultimately requiring dialysis and/or a kidney transplant,” stated a senior official associated with the study.”Future research is needed to fully understand the long-term impact of these diseases on individuals diagnosed at a young age.”
The research team also emphasized the importance of including children in clinical trials evaluating new treatments. “Our research highlights the importance of including children in clinical trials for disease treatment to mitigate against the adverse outcomes they face,” added a co-author from Emory University School of Medicine.
The study reinforces the message that while the rate of kidney function decline may not differ dramatically with age, the lifetime risk of kidney failure is demonstrably higher for those diagnosed earlier in life. This underscores the need for proactive monitoring and potentially more aggressive interventions in younger patients with primary glomerular disease.
