The following is the summary of “Quantifying relationship between the remission duration and the cardiovascular and kidney outcomes in the patients with primary nephrotic syndrome” published in the November 2022 issue of Renal failure by Lia, et al.
Patients with chronic proteinuria in the nephrotic range are at increased risk for kidney damage and cardiovascular problems. Recent evidence suggests that keeping proteinuria in remission lowers the likelihood of a kidney endpoint. However, it is still not apparent how long someone is in remission affects their cardiovascular prognosis. About 982 people with primary nephrotic syndrome who had gone into clinical remission were included in this study. The length of the first remission was measured in terms of its upkeep time in months. The primary outcomes were death from Arteriosclerotic cardiovascular disease (ASCVD) and kidney failure (end-stage kidney disease [ESKD] or eGFR drop >50%).
Limiting periods of time were identified using methods such as survival analysis, Cox regression modeling, and restricted cubic spline analysis. A total of 161 patients (16.4%) were diagnosed with ASCVD (51.3 per 1,000 patient-years), and 52 patients (5.3%) were diagnosed with kidney dysfunction during the 38.3-month follow-up period (15.3 per 1000 patient-years). Each additional year of remission was related to a 15% reduction in risk (HR, 0.854; 95% CI, 0.776 0.940, P=.001) of ASCVD, as determined by multivariate analysis. Remission’s preventive impact against ASCVD was first seen at seven months and lasted for as long as 36 months.
The time spent in remission was also a safeguard against kidney failure. This effect was visible immediately, peaking at 26 months after the remission had started. In individuals with nephrotic syndrome, better cardiovascular and kidney outcomes were seen with diligent attention to keeping proteinuria in remission.
Source: tandfonline.com/doi/full/10.1080/0886022X.2022.2143377