A form of kidney disease called primary nephrotic syndrome is characterized by high urinary protein excretion, low protein in the blood, high cholesterol, and swelling in the arms and legs. Patients may face several negative health outcomes, but the extent of these effects is unknown. In a study that appears in an upcoming issue of JASN, the researchers evaluated renal, cardiovascular, and mortality outcomes in adults with primary nephrotic syndrome.
Alan S. Go, MD (Northern California Research Division, Kaiser Permanente) and colleagues examined data from a large integrated health care system to identify adults with primary nephrotic syndrome over a period of 16 years. The researchers compared the long-term kidneys of 907 patients cardiovascular results with those of 89,593 adults without kidney disease.
During a mean follow-up of 4.5 years, adults with primary nephrotic syndrome had a 19.63-fold higher risk of developing renal failure, a 2.58-fold higher risk of acute coronary syndrome, a 3.01-fold higher risk of heart failure, a 1.80-fold higher risk of ischemic stroke, a 2.56-fold higher risk of venous thromboembolism and a 1.34-fold higher risk of death compared to controls.
Primary nephrotic syndrome can result from diseases called minimal changes, focal segmental glomerulosclerosis, or membranous nephropathy. In this study, focal segmental glomerulosclerosis was associated with an increased risk of renal failure, followed by membranous nephropathy and minimal change disease, but there were no significant differences in the risks of cardiovascular complications or death due to primary nephrotic syndrome.
“Our study highlights the high risk of renal failure and overestimated risk of various arterial and venous cardiovascular complications related to primary nephrotic syndrome due to focal segmental glomerulosclerosis, membranous nephropathy, or minimal change disease. Additional information is needed on the most effective ways to reduce the risk of kidney and cardiovascular complications in patients, ”said Drs. Go. “Our study also points to the need for patients with primary nephrotic syndrome to be identified as soon as possible so that they can begin to apply lifestyle changes, such as moving toward a healthy diet, quit smoking, get more exercise and be evaluated for preventive therapies that can reduce the risk of cardiovascular disease and kidney failure “.
Alan Go et al, Primary nephrotic syndrome and end-stage renal disease risks, cardiovascular events and death: a study of Kaiser’s permanent nephrotic syndrome, Journal of the American Society of Nephrology (2021). DOI: 10.1681 / ASN.2020111583
American Society of Nephrology
Citation: Study Examines Cardiac and Renal Outcomes of Adults with Nephrotic Syndrome (2021, June 19) Retrieved June 19, 2021 at https://medicalxpress.com/news/2021-06-heart-kidney-outcomes -adults-nephrotic.html
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