Abstract: FR-PO0855
Prognostic Differences Between Proteinuria Remissions with and Without Initial Corticosteroids in Patients with IgAN
Session Information
- Glomerular Outcomes: From Proteinuria to Prognosis
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Glomerular Diseases
- 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics
Authors
- Fujimoto, Toshinari, The Jikei University School of Medicine, Tokyo, Japan
- Hirano, Keita, The Jikei University School of Medicine, Tokyo, Japan
- Okabe, Masahiro, The Jikei University School of Medicine, Tokyo, Japan
- Sasaki, Takaya, The Jikei University School of Medicine, Tokyo, Japan
- Koike, Kentaro, The Jikei University School of Medicine, Tokyo, Japan
- Ueda, Hiroyuki, The Jikei University School of Medicine, Tokyo, Japan
- Tsuboi, Nobuo, The Jikei University School of Medicine, Tokyo, Japan
- Yasuda, Takashi, Naruse Jin clinic, Tokyo, Japan
- Yasuda, Yoshinari, Gifu University, Gifu, Japan
- Matsuzaki, Keiichi, Kitasato University School of Medicine, Kanagawa, Japan
- Maruyama, Shoichi, Nagoya University Graduate School of Medicine, Aichi, Japan
- Suzuki, Yusuke, Juntendo University Faculty of Medicine, Tokyo, Japan
- Yokoo, Takashi, The Jikei University School of Medicine, Tokyo, Japan
Background
A significant proportion of patients with IgA nephropathy (IgAN) exhibit a reduction in proteinuria to a remission level during the early phase following supportive care either with or without corticosteroid treatment. However, the long-term prognostic differences following proteinuria remission between patients initially treated with corticosteroids and those who did not remain unclear.
Methods
Using a Japanese multicenter retrospective cohort study dataset, we enrolled 852 patients existing proteinuria value at one year of follow-up. Exposure was corticosteroids within the first year of follow-up (n=390). The primary outcome was a 50% increase in serum creatinine from baseline. Secondary outcomes were overt proteinuria (>0.3g/day) and overt hematuria (>2+) at the end of follow-up. Proteinuria remission was defined as <0.3g/day. Overlap weighting by propensity score was used to adjust the differences in baseline characteristics between patients receiving initial corticosteroids and others.
Results
Initial corticosteroid treatment was favorably associated with primary outcome in patients with and without proteinuria remission at one year of follow-up (hazard ratio 0.50, 95% confidence interval 0.25-0.95, P for interaction 0.83). In a subgroup of patients with proteinuria remission at one year of follow-up (n=480), initial corticosteroid treatment was associated with a lower risk of overt proteinuria (odds ratio 0.55, 95% confidence interval 0.39-0.77) and hematuria at the end of follow-up (odds ratio 0.56, 95% confidence interval 0.38-0.83).
Conclusion
In patients with IgAN who experienced proteinuria remission at one year of follow-up, initial corticosteroid use was associated with improved renal survival. In addition, the initial corticosteroids may lower the chance of relapse.