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Abstract: SA-PO949

Comparative Analysis of Clinical and Pathological Traits in IgA Nephropathy with Nephrotic Range Proteinuria Based on Serum Albumin Level

Session Information

Category: Glomerular Diseases

  • 1402 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

  • Eum, Sang Hun, Incheon St. Mary's Hospital, Incheon, Korea (the Republic of)
  • Min, Ji Won, Bucheon St. Mary's Hospital, Bucheon, Korea (the Republic of)
  • Koh, Eun Sil, Yeouido St. Mary's Hospital, Seoul, Korea (the Republic of)
  • Ban, Tae Hyun, Eunpyeong St. Mary's Hospital, Seoul, Korea (the Republic of)
  • Hong, Suyeon, Uijeongbu St. Mary's Hospital, Uijeongbu, Korea (the Republic of)
  • Hong, Yu Ah, Daejeon St. Mary's Hospital, Daejeon, Korea (the Republic of)
  • Chung, Byung ha, Seoul St. Mary's Hospital, Seoul, Korea (the Republic of)
  • Kim, Yong Kyun, St. Vincent's Hospital, Suwon, Korea (the Republic of)
  • Shin, Seok Joon, Incheon St. Mary's Hospital, Incheon, Korea (the Republic of)
  • Yoon, Hye Eun, Incheon St. Mary's Hospital, Incheon, Korea (the Republic of)
Background

Presently, the clinical outcomes associated with IgA nephropathy exhibiting heavy proteinuria and the potential correlation between decreasing serum albumin levels and adverse prognosis have not been conclusively established. The present study was designed to elucidate the clinical and pathological characteristics of IgA nephropathy patients who present with nephrotic-range proteinuria, particularly in relation to serum albumin levels.

Methods

This retrospective study was conducted using data from biopsy-confirmed IgA nephropathy patients presenting with nephrotic-range proteinuria between 2017 and 2022 from eight university-affiliated hospitals in South Korea. Patients were stratified into two groups based on a serum albumin level of 2.5g/dl. The study involved a comparative assessment of clinical and pathological characteristics across these two groups, as well as an evaluation of clinical prognosis with respect to the end-stage kidney disease (ESKD).

Results

The analysis included a total of 105 patients. Of these, 86 patients had a serum albumin level above 2.5g/dl (designated as the preserved albumin group, or PA group), while 19 patients had levels below 2.5g/dl (designated as the decreased albumin group, or DA group). The baseline characteristics of the two groups were found to be statistically similar. The mean age of the patients was 46.25 years, and 45.71% were male. Serum erythrocyte sedimentation rate, total cholesterol and low-density lipoprotein-cholesterol levels were significantly higher in the DA group. Pathological findings revealed more pronounced global sclerosis, interstitial fibrosis, and tubular atrophy in the PA group. Diffuse foot process effacement was more prominent in the DA group. During a median follow-up period of 23.64 months (range 0.03-69.53 months), 22 patients (25.58%) in the PA group progressed to ESKD, compared with 1 patient (5.26%) in the DA group. There was no statistically significant difference between the two groups in terms of progression to ESKD (P = 0.055).

Conclusion

In patients with IgA nephropathy presenting with nephrotic-range proteinuria, a decline in serum albumin levels was associated with less chronic lesions, and it was not found to be associated with adverse prognosis.