Kidney disorder linked to risk of developing cardiovascular and end-stage kidney diseases

June 25, 2021

Adults diagnosed with the kidney condition known as primary nephrotic syndrome are at high risk of developing end-stage kidney disease and cardiovascular disease, new research from the Kaiser Permanente Division of Research shows as reported in news release.

The findings, reported in the Journal of the American Society of Nephrology, are from The Kaiser Permanente Nephrotic Syndrome Study.

“Primary nephrotic syndrome is not a very common disorder, and we wanted to do this study because there may be a general underappreciation of the wide range of complications that people with this syndrome experience,” said the study’s lead author Alan S. Go, MD, Senior Research Scientist at the Kaiser Permanente Division of Research. “The higher risk of developing end-stage kidney disease would be more expected. But more importantly we were able to show the increased risk for different kinds of cardiovascular events, and that’s less appreciated in the medical community.”

Primary nephrotic syndrome is a condition that occurs when a person develops a disease that damages the small blood vessels near the part of the kidneys that filters waste from the blood. These diseases cause a protein called albumin to seep into the urine instead of being returned to the bloodstream. It can be diagnosed through a urine test, a blood test, or a kidney biopsy.

The new study compared the health outcomes of 907 adults with primary nephrotic syndrome treated in Kaiser Permanente Northern California (KPNC) between 1996 and 2012 with those of 89,593 healthy KPNC members. In their comparative analyses, the researchers accounted for factors that could influence the findings, such as the study participants’ age, gender, and socioeconomic status as well as their other health conditions.

The study found that over a median of 4.5 years of follow-up, the patients with primary nephrotic syndrome were 20 times more likely to develop end-stage kidney disease and 2 to 3 times more likely to have a heart attack, stroke, heart failure, or to develop a blood clot in a deep vein. In addition, the patients with primary nephrotic syndrome had a 34% higher rate of death.

The study also compared outcomes for patients with the 3 diseases most likely to cause primary nephrotic syndrome: minimal change disease, focal segmental glomerulosclerosis (FSGS), and membranous nephropathy (MN). These analyses showed the risk for end-stage kidney disease was significantly higher in patients with FSGS and MN than in patients with minimal stage disease. People with end-stage kidney disease must have routine dialysis or a kidney transplant to extend their lives.

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