ArticleNephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association2025
Albuminuria predicts kidney events in IgA nephropathy.
Article in Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 3 of them syntheses that pooled it.
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Who cites it
24 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- The Association between Low-Grade Proteinuria and Adverse Kidney Outcomes in IgA Nephropathy: A Systematic Review and Meta-Analysis.Clinical journal of the American Society of Nephrology : CJASN · 2026Pooled it
- Association between different proportions of crescents and adverse renal outcomes in immunoglobulin a nephropathy: a systematic review and meta-analysis.Renal failure · 2025Pooled it
- Lower proteinuria is better for patients with IgA nephropathy: a systematic review.Frontiers in nephrology · 2025Pooled it
- IgA nephropathy: an overview of the disease, its pathophysiology, and involvement of the gut-kidney axis.Kidney international supplements · 2026Review
- Urine albumin-to-creatinine ratio as a predictor of kidney function decline in Alport syndrome.Clinical kidney journal · 2026Article
- Zigakibart Potently Inhibits A Proliferation-Inducing Ligand-Mediated IgA Production, Addressing IgAN Pathogenesis Root Causes.Kidney international reports · 2026Article
- Measuring effectiveness in immunoglobulin A nephropathy: what are we looking for?Clinical kidney journal · 2026Article
- Albuminuria or proteinuria in glomerular disease and CKD-which one to use?Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2026Article
- The correlation between cardiac structure and renal function deterioration in patients with metabolic kidney disease: a cohort study.BMC nephrology · 2026Observational
- IgA Nephropathy: Epidemiology, Outcomes, and Insights for Primary Glomerulonephritides.Journal of clinical medicine · 2026Review
- Evaluation of objective nutritional indices as predictors of renal progression in IgA nephropathy patients.Frontiers in nutrition · 2026Article
- Defining Disease Modification in IgA Nephropathy: Toward a Paradigm Shift in Management.Kidney international reports · 2025Review
- Prognostic value of albuminuria in IgA nephropathy: insights from a real-world cohort.Clinical kidney journal · 2025Article
- Urinary Albumin-to-Creatinine Ratio, Cardiovascular Health, and All-Cause Mortality in Hypertension: A Nationwide Cohort Analysis.Journal of clinical hypertension (Greenwich, Conn.) · 2025Article
- Association Between Relapse and Long-Term Kidney Outcomes in IgA Nephropathy.Kidney medicine · 2025Article
- The 2025 KDIGO IgA nephropathy guideline update: an ERA Immunonephrology Working Group perspective.Clinical kidney journal · 2025Article
- The Swedish Renal Registry: a nationwide registry for chronic kidney disease of all stages.Clinical kidney journal · 2025Article
- Proteinuria Trajectory and Disease Progression in Children and Adults with IgA Nephropathy/Vasculitis.Clinical journal of the American Society of Nephrology : CJASN · 2025Article
- Lifetime progression of IgA nephropathy: a retrospective cohort study with extended long-term follow-up.BMC nephrology · 2025Article
- Primary glomerular diseases and long-term adverse health outcomes: A nationwide cohort study.Journal of internal medicine · 2025Article
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Authors and funding
7 authors.
Funding
Abstract
background and hypothesisKDIGO recommends proteinuria <1 g/d as a treatment target in patients with immunoglobulin A nephropathy (IgAN) because of high risk of progression to kidney failure. However, long-term kidney outcomes in patients with low-grade proteinuria remain insufficiently studied.
methodsWe enrolled patients with biopsy-proven primary IgAN from the Swedish Renal Registry and analyzed associations between urine albumin-to-creatinine ratio (uACR, in categories <0.3, 0.3-0.5, 0.5-1.0, 1.0-1.5, 1.5-2.0, and ≥2.0 g/g) and the occurrence of major adverse kidney events [MAKE, a composite of kidney replacement therapy (KRT) and >30% decline in estimated glomerular filtration rate (eGFR)]. We also explored the risk of kidney events associated with change in uACR within a year.
resultsWe included 1269 IgAN patients (74% men, median 53 years, mean eGFR 33 ml/min/1.73 m², median uACR 0.7 g/g). Over a median follow-up of 5.5 [2.8; 9.2] years, 667 MAKE and 517 KRT events occurred, and 528 patients experienced >30% eGFR decline. Compared with uACR < 0.3 g/g, any higher uACR category was strongly and incrementally associated with the risk of MAKE [adjusted hazard ratios (HR) ranging from 1.56 (95%CI 1.14-2.14) if uACR 0.3-0.5 g/g to 4.53 (3.36-6.11) if uACR ≥ 2.0 g/g], KRT (HR ranging from 1.39 to 4.65), and eGFR decline >30% (HR ranging from 1.76 to 3.47). In 785 patients who had repeated uACR measurements within a year, and compared with stable uACR, the risk of kidney events was lower if uACR decreased by 2-fold (HR ranging from 0.47 to 0.49), and higher if uACR increased by 2-fold (HR from 1.18 to 2.56), irrespective of baseline uACR.
conclusionsThere is substantial risk of adverse kidney outcomes among patients with IgAN and uACR between 0.3 and 1.0 g/g, a population currently considered at low risk of CKD progression. Reduction in uACR is associated with better kidney outcomes, irrespective of baseline uACR.
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