Table 4.
Comparison of relapses that occur at ≤1, 1–2, >2 years after a remission event
| Variables | Relapse ≤1 yr (Group 1, n = 108) | Relapse 1–2 yrs (Group 2, n = 31) | Relapse >2 yrs (group 3, n = 38) | P-value |
|---|---|---|---|---|
| Nephrotic period leading to the remission | ||||
| Sex, % female | 34 | 23 | 39 | 0.32 |
| Initial age, yrs | 45 ± 15 | 40 ± 14 | 42 ± 14 | 0.25 |
| Initial eGFR, ml/min per 1.73 m2 | 68 ± 26 | 69 ± 28 | 75 ± 29 | 0.39 |
| Maximal proteinuria, g/d | 9.3 (5.9–12.0) | 6.5 (5.0–11.0) | 5.8 (4.8–7.6) | 0.003 (1>3) |
| Nadir albumin, g/l | 29 ± 8 | 27 ± 9 | 28 ± 8 | 0.68 |
| Initial MAP, mm Hg | 103 ± 12 | 101 ± 13 | 97 ± 15 | 0.02 |
| Initial number of blood pressure medication | 1 (0–2) | 1 (0–2) | 1 (0–2) | 0.51 |
| Initial use of RASB, % | 38 | 36 | 37 | 0.97 |
| Treatments, % | ||||
| % none, glucocorticoids, antimetabolites, B-cell therapy, CNI | 21, 47, 4, 8, 20 | 19, 29, 10, 13, 29 | 21, 45, 3, 10, 21 | 0.70 |
| Time from onset of nephrotic proteinuria to immunosuppression start | 0 (0–4) | 1 (0–4) | 0 (0–2) | 0.76 |
| Time from immunosuppression start to remission | 4 (2–10) | 3 (1–7) | 4 (2–6) | |
| Remission period | ||||
| Time to remission (partial remission criteria) | 9 (3–21) | 7 (4–18) | 5 (3–11) | 0.23 |
| eGFR at remission, ml/min per 1.73 m2 | 63 ± 29 | 69 ± 31 | 70 ± 31 | 0.36 |
| Reduction in eGFR from nephrotic period onset | 5 ± 21 | 1 ± 25 | 5 ± 16 | 0.66 |
| Nadir proteinuria, g/d | 1.6 (0.7–2.6) | 1.9 (0.7–2.4) | 0.6 (0.2–1.5) | <0.001 (1,2<3) |
| Reduction in proteinuria from maximal value | 6.5 (4.1–10.2) | 4.9 (3.1–10.8) | 5 (3.6–6.0) | 0.06 |
| Complete / partial remission, % | 15 / 85 | 23 / 77 | 39 / 61 | 0.006 (1<3) |
| Maximal albumin, g/l | 38 ± 6 | 39 ± 6 | 42 ± 4 | 0.004 (1<3) |
| Increase in albumin from minimal value | 9 ± 7 | 12 ± 10 | 13 ± 9 | 0.04 (1<3) |
| MAP at remission, mm Hg | 98 ± 13 | 97 ± 11 | 95 ±10 | 0.32 |
| Reduction in MAP from nephrotic period onset | 5 ± 13 | 4 ± 15 | 4 ± 14 | 0.78 |
| Number of blood pressure medication at remission | 2 (1–2) | 1 (0–2) | 1 (0–2) | 0.04 (1>3) |
| Use of RASB at remission, % | 63 | 48 | 50 | 0.20 |
| Time from remission to immunosuppression end | 3 (1–6) | 13 (0–18) | 21 (2–32) | <0.001 (1<3) |
| Time from remission to relapse | 4 (3–7) | 17 (14–21) | 40 (28–50) | By definition |
| IS at time of relapse, % not given, stopped, taper, maintenance | 20, 30, 27, 23 | 19, 52, 13, 16 | 21, 47, 21, 11 | 0.17 |
CNI, calcineurin inhibitor; eGFR, estimated glomerular filtration rate; IS, immunosuppression; MAP, mean arterial pressure; RASB, renin angiotensin system blockade.
All times are in months.