Young Adults With Glomerular Disease May Require Distinct Care

New research suggests young adults with glomerular disease may experience different rates of relapse, kidney function decline, and first observed remission compared with adult or pediatric patients.1

These data include adults, young adults, and pediatric patients with IgA nephropathy (IgAN), minimal change disease (MCD), and focal segmental glomerulosclerosis (FSGS), with study investigators calling for the need to implement age-differentiated care.1

Often, when defining disease trajectories and outcomes in glomerular disease, investigations are limited to age groups classified between pediatric and adult divisions. This study aims to address the research gaps in the young adult age threshold by defining young adults as a definitive group in analysis.1

“Glomerular disease is a prominent cause of kidney disease in adolescents and young adults, yet there is limited information on how this population fares compared to children and older adults,” wrote Andrew Vissing, MD, an attending physician and assistant professor at Northwestern University Feinberg School of Medicine, along with fellow study investigators of Cure Glomerulonephropathy (CureGN).1,2

The retrospective observational study utilized data from CureGN, a multi-center, international consortium of children and adults with biopsy-proven glomerular disease. Specifically, investigators assessed patients with MCD, FSGS, and IgAN.1,2

Study investigators stratified patients into the following age-based groups: pediatric patients ≤ 13 years of age, young adults 14 to 25 years of age, and adults ≥ 26 years of age, and compared them by demographic, clinical, and disease characteristics.1

Investigators assessed associations between age group and relapse rate, change in kidney function defined by estimated glomerular filtration rate (eGFR), and time to remission using multivariate negative binomial, linear mixed effects, and Cox proportional hazards models, stratifying each by disease type.1

Investigators noted a median follow-up time of 4.9 years among all age groups and glomerular diseases.1

The study included a total of 1868 patients with glomerular disease. There were 526 pediatric patients, 397 young adults, and 909 adults.1

Upon analysis, investigators observed differences and similarities between the age groups in MCD. For example, adults with MCD recorded few relapses (Incidence Rate Ratio [IRR], 0.61; Confidence Interval [CI], 0.41-0.91; P = .01) compared to young adults, while there was no difference between pediatric patients with MCD (IRR 1.23; CI 0.85-1.79; P = .28). Furthermore, pediatric participants with MCD achieved first observed remission sooner compared to young adults (Hazard Ratio [HR], 2.18; CI, 1.03-4.63; P = .04).1

In IgAN, investigators reported fewer relapses in adults compared to young adults (IRR, 0.55; CI, 0.33 – 0.94; P = .03). Additionally, adults with IgAN were slower to achieve first observed remission compared to young adults (HR, 0.58; CI, 0.37-0.91; P = .02).1

When examining FSGS, investigators found a faster decline in kidney function in young adults (1.7 ml/min/1.73m2 per year) compared to pediatric patients (0.3 ml/min/1.73m2 per year; P = .008).1

“Young adults with glomerular disease exhibit distinct clinical patterns compared to the pediatric and adult age groups, underscoring the need to approach care and research along an age-related continuum rather than a binary framework,” concluded investigators.1

References

1. Vissing A, Fishbein J, Smith AR, et al. Is Age Just a Number? Kidney360. Published online December 23, 2025. doi:https://doi.org/10.34067/kid.0000001090

2. An Observational Cohort Study of Glomerular Disease: The CureGN Consortium. Curegn.org. Published 2023. Accessed January 7, 2026. https://www.curegn.org/‌