Kidney Week

Abstract: SA-PO0795

Treatment Goals in IgAN: Gaps Between Expectations and Outcomes

Session Information

• Glomerular Research: Design, Registries, Surveys, and Epidemiology
  November 08, 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

• Csomor, Philipp, Vifor Pharma Management AG, Glattbrugg, Zurich, Switzerland

Philipp Csomor, PhD

• Hurtado, Tucker Bittel, Spherix Global Insights, Exton, Pennsylvania, United States

Tucker Bittel Hurtado, MPH

• Lafave, Jennifer, Spherix Global Insights, Exton, Pennsylvania, United States

Jennifer Lafave

• Santos, Lucy, Vifor Pharma Management AG, Glattbrugg, Zurich, Switzerland

Lucy Santos, PharmD

Background

IgA nephropathy (IgAN) is a common cause of chronic kidney disease and kidney failure. Higher proteinuria and lower estimated glomerular filtration rate (eGFR) are associated with risk of progression to kidney failure, even in patients historically considered low risk. Guidelines advocate targeting lower proteinuria levels, supported by novel treatment approaches. This study compared the treatment goals of European physicians managing individuals with IgAN with patient chart data to identify potential unmet clinical needs.

Methods

Between 9 January and 5 February 2025, physicians from France, Germany, Italy, Spain and the UK completed a questionnaire on IgAN management and a patient chart audit. Physicians were required to have ≥50 patients with Stage 1–4 chronic kidney disease (CKD), including ≥4 patients who were not on dialysis. Patients to be included had to be ≥13 years old, have non-dialysis IgAN and an eGFR ≥15 mL/min/1.73 m².

Results

317 physicians completed the questionnaire and chart audits on 507 patients with IgAN. 88% of respondents agreed that reducing proteinuria to <0.5 g/day will result in preserved eGFR and better renal survival in IgAN patients, and 77% would reduce their treatment threshold for urine protein–creatinine ratio (UPCR) to 0.5 g/day. However, the patient chart audit showed only 25% of patients had UPCR/24-hour proteinuria ≤0.5 g/day, and 41% had UPCR/24-hour proteinuria >1 g/day. Similarly, 79% of physicians agreed that preservation of kidney function as indicated by a stabilised eGFR was the main treatment goal for their IgAN patients. Yet, the patient chart audit showed that 72% of patients were at CKD Stage 3 or 4 (defined by their most recent eGFR measuring between 15 and 59 mL/min/1.73 m²) and 81% of patients had a perceived eGFR decline of ≥1 mL/min/1.73 m² per year.

Conclusion

Although a majority of physicians seem to agree with aiming towards more stringent treatment goals including lower proteinuria targets than previously recommended and stabilising eGFR, most patients with IgAN are not achieving the targets, highlighting an unmet clinical need for effective treatment approaches.

Funding

• Commercial Support – Spherix Global Insights and Vifor (International) AG

Digital Object Identifier (DOI)

• doi: 10.1681/ASN.2025wzmdnyf5