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Kidney Week

Abstract: FR-PO0842

Time to Biopsy in IgAN

Session Information

Category: Glomerular Diseases

  • 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics

Authors

  • Stoneman, Sinead, The University of British Columbia, Vancouver, British Columbia, Canada
  • Han, Jialin, The University of British Columbia, Vancouver, British Columbia, Canada
  • Barratt, Jonathan, University of Leicester, Leicester, England, United Kingdom
  • Atiquzzaman, Mohammad, The University of British Columbia, Vancouver, British Columbia, Canada
  • Barbour, Sean, The University of British Columbia, Vancouver, British Columbia, Canada
Background

IgA nephropathy [IgAN] carries a high lifetime risk of kidney failure. Population-level studies facilitate analysis of health care utilization that may impact IgAN diagnosis and outcomes.

Methods

We investigated time to biopsy using a population-level cohort of adults ≥18 years with IgAN in the provincial Glomerulonephritis [GN] Registry. The registry captures all patients with a biopsy diagnosis of IgAN from January 1, 2000 to December 31, 2020.

Results

The GN Registry captured 1382 individuals with primary IgAN from 2000 to 2020. Between 2000-2005, the mean time from first nephrology visit to biopsy was 332 days, which increased to 713 days between 2015-2020. Over time, we observed increasing age (from mean of 43 to 46 years), decreasing eGFR (from median of 62 to 49 ml/min/1.73m2) and increasing baseline comorbidities at the time of biopsy (Table 1). Patients with a time from first nephrology visit to biopsy greater than 365 days had a 20-year ESKD risk of 50%; those with a time from first visit to biopsy between 15 and 60 days had a 20-year ESKD risk of 40% (figure 2).

Conclusion

We observed an unexpected increase in the time to kidney biopsy in a population cohort of adult IgAN patients. Consistent with this, patients were older, more comorbid and had more advanced disease with lower eGFR at the time of biopsy. We are integrating MEST-C scores to see if this delay in diagnosis is associated with more advanced sclerotic disease at biopsy. We are currently investigating clinical, health system and socioeconomic factors that may explain this trend and difference in ESKD risk.

Table 1

Funding

  • Commercial Support – Novartis AG

Digital Object Identifier (DOI)