ArticleNephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association2025
CKD progression, kidney failure, and mortality among US patients with 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 20 papers, 3 of them syntheses that pooled it.
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Who cites it
20 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Prognostic value of vascular lesions in immunoglobulin a nephropathy: a meta-analysis.BMC nephrology · 2026Pooled 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
- Lower proteinuria is better for patients with IgA nephropathy: a systematic review.Frontiers in nephrology · 2025Pooled it
- Targeting the B-Cell Activating Factor and a Proliferation-Inducing Ligand Pathway in IgAN: From Disease Pathogenesis to Clinical Trial Evidence.Kidney international reports · 2026Review
- Predictors of response and long-term tolerability of sparsentan in a real-world IgA nephropathy cohort.Clinical kidney journal · 2026Article
- The Alternative Complement Pathway in IgA Nephropathy: A Podcast for Advanced Practice Providers.Advances in therapy · 2026Article
- Re-evaluation of the prognosis of patients with IgA nephropathy and mild proteinuria: a longitudinal study with unexpected results.Inflammation research : official journal of the European Histamine Research Society ... [et al.] · 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
- Inhibition of p65 NF-κB enhances production of galactose-deficient IgA1 through suppression ofbioRxiv : the preprint server for biology · 2026Article
- IgA Nephropathy: Mechanisms, Risk Stratification, and Precision Therapy.Diagnostics (Basel, Switzerland) · 2026Review
- Correlation Between Systemic Inflammation Response Index and Systemic Immune-Inflammation Index and Disease Activity of Lupus Nephritis in Children.Children (Basel, Switzerland) · 2026Article
- Prognostic value of the ratio of globally sclerotic glomeruli in patients with idiopathic IgA nephropathy.Scientific reports · 2026Article
- Aberrant signaling in tonsillar B cells producing pathogenicFrontiers in immunology · 2026Review
- Comparison of efficacy and safety of systemic glucocorticoids and Nefecon in IgA nephropathy patients: a real-world retrospective cohort study.Frontiers in immunology · 2026Article
- Clinical Characteristics as Predictors of Healthcare Resource Utilization in Immunoglobulin A Nephropathy: A Retrospective Database Study.Journal of health economics and outcomes research · 2026Article
- Canadian Society of Nephrology Commentary on the Evolving Kidney Disease Improving Global Outcomes Adult Glomerulonephritis Guidelines.Canadian journal of kidney health and disease · 2026Article
- Defining Disease Modification in IgA Nephropathy: Toward a Paradigm Shift in Management.Kidney international reports · 2025Review
- Accuracy of ICD-10 coding for identifying immunoglobulin A nephropathy (IgAN) prior to 2023.Clinical kidney journal · 2025Article
- Opportunities and challenges in the treatment of IgA nephropathy.Frontiers in pharmacology · 2025Review
- Progression of immunoglobulin A nephropathy (IgAN) in a Hispanic/Latinx population in the United States.Frontiers in nephrology · 2025Article
Corrections and comments
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Authors and funding
9 authors.
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Abstract
background and hypothesisWe assessed disease progression among patients with immunoglobulin A nephropathy (IgAN) and characterized factors associated with risk for adverse outcomes.
methodsA retrospective longitudinal cohort (2000-2022) study of adults with biopsy-confirmed IgAN within Kaiser Permanente Southern California was performed. The outcome of interest was a composite of ≥50% estimated glomerular filtration rate (eGFR) decline, kidney failure, or mortality. Cox proportional hazards regression modeling was used to estimate hazard ratios (HR) for the eGFR decline/kidney failure with adjustment for potential confounders.
resultsAmong 655 patients with primary IgAN (31% Asian/Pacific Islander, 3% Black, 40% Hispanic/Latino, 24% White), 234 (36%) reached the composite outcome of ≥50% eGFR decline (17%), kidney failure (16%), or mortality (3%). The composite outcome occurred at a rate of 79.4 events (95% confidence intervals (CI) 69.6, 90.7) per 1000 patient-years, with a median time to event of 2.7 years. Compared to urine protein creatinine ratio (UPCR) <0.5 vs 0.5-<1 g/g, 1-2, and >2 g/g, the HR (95% CI) for ≥50% eGFR decline/kidney failure were 2.4 (1.1, 5.1), 3.2 (1.5, 6.6), and 5.1 (2.5, 10.4) for baseline UPCR and 5.4 (2.3, 13.0), 14.4 (16.5, 32.2), and 41.2 (17.9, 94.5) for time-averaged UPCR. Lower baseline eGFR and diabetes were also associated with higher risk, while age ≥30 years was associated with lower risk for ≥50% eGFR decline/kidney failure. There were no clear trends differentiating risk by race/ethnicity.
conclusionIn this large, diverse cohort, high rates of kidney outcomes occurred within a relatively short follow-up duration. Our findings suggest that IgAN carries elevated risk for kidney outcomes starting at proteinuria levels ≥0.5 g/g, in contrast to earlier perceptions that levels below 1 g/g are associated with low risk.
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