A form of kidney disease called primary nephrotic syndrome is characterized by high urinary excretion of protein, low protein in the blood, high cholesterol, and swelling in the arms and legs. Patients may face a range of negative health outcomes, but the extent of these effects are unknown. In a study appearing in an upcoming issue of JASN, investigators evaluated kidney, cardiovascular, and mortality outcomes in adults with primary nephrotic syndrome.

Alan S. Go, MD (Kaiser Permanente Northern California Division of Research) and his colleagues examined data from a large, integrated healthcare delivery system to identify adults with primary nephrotic syndrome over a 16-year period. The researchers compared 907 patients’ long-term kidney and cardiovascular outcomes with those from 89,593 adults without kidney disease.

Over a median follow-up of 4.5 years, adults with primary nephrotic syndrome had a 19.63-times higher risk of developing kidney failure, a 2.58-times higher risk of acute coronary syndrome, a 3.01-times higher risk of heart failure, a 1.80-times higher risk of ischemic stroke, a 2.56-times higher risk of venous thromboembolism, and a 1.34-times higher risk of death compared with controls.

Primary nephrotic syndrome can result from diseases called minimal change disease, focal segmental glomerulosclerosis, or membranous nephropathy. In this study, focal segmental glomerulosclerosis was associated with the highest risk of kidney failure, followed by membranous nephropathy and minimal change disease, but there were no significant differences in the risks of cardiovascular complications or death by cause of primary nephrotic syndrome.

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