Abstract: TH-PO0479
Contributions of IgAN to Kidney Failure: Global Trends from DOPPS
Session Information
- Glomerular Diseases: Clinical, Outcomes, and Therapeutics Research - IgAN
October 22, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Glomerular Diseases
- 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics
Authors
- Fuller, Sammantha B., Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
- Bieber, Brian, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
- Alencar de Pinho, Natalia, Centre de Recherche en Epidemiologie et Sante des Populations, Villejuif, Île-de-France, France
- AlSahow, Ali, Al Jahra Hospital, Jahra, Al Jahra Governorate, Kuwait
- Barratt, Jonathan, University of Leicester, Leicester, England, United Kingdom
- Dasgupta, Indranil, University Hospitals Birmingham NHS Foundation Trust, Birmingham, England, United Kingdom
- Jadoul, Michel, Cliniques universitaires Saint-Luc, Brussels, Belgium
- Johnson, David W., Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
- Nitta, Kosaku, Tokyo Joshi Ika Daigaku, Shinjuku, Tokyo, Japan
- O'Byrne, Megan Michelle, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
- Rizk, Dana V., University of Alabama at Birmingham Health System, Birmingham, Alabama, United States
- Schaeffner, Elke, Charite - Universitatsmedizin Berlin, Berlin, BE, Germany
- Udani, Suneel M., Nephrology Associates, Oak Park, Illinois, United States
- Zuo, Li, Peking University People's Hospital, Beijing, China
- Karaboyas, Angelo, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
- Pecoits-Filho, Roberto, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
Background
IgA nephropathy (IgAN) is the most common primary glomerular disease worldwide. While IgAN is well studied earlier in its disease course, less is known about its contribution to kidney failure (KF) requiring hemodialysis (HD) across geographic regions and in the context of broader glomerulonephritis (GN) trends.
Methods
We analyzed data from 111,795 patients in the Dialysis Outcomes and Practice Patterns Study (DOPPS), an international cohort of in-center HD patients. Analyses were restricted to regions with sufficient sample sizes across DOPPS phases 1-6 (1996-2018) and patients with reliable ascertainment of the primary cause of KF. IgAN was defined as biopsy-confirmed IgAN as the primary cause of KF at study entry, ascertained via medical questionnaire completed by study coordinator. We estimated IgAN prevalence by region and DOPPS phase and compared with GN trends, classifying GN into 3 mutually exclusive groups (Figure 1) by histologic confirmation status.
Results
The contribution of GN as primary cause of KF declined over time in most regions, particularly in Japan from 57% to 32% across the study period. Among GN patients, we observed a shift from non-histologically confirmed GN to specific confirmed GN subtypes across all regions (e.g., from 52% to 25% non-confirmed in North America). The contribution of IgAN as primary cause of KF varied markedly across regions, from 3-5% in Japan and 3-4% in Europe/Australia-New Zealand to 2% in China and 1% in North America and the Gulf Cooperation Council (GCC) region.
Conclusion
The shift to confirmed specific GN diagnoses in all regions suggests improving diagnostic specificity over time, likely reflecting greater use of biopsy and more granular GN reporting as a cause of KF needing dialysis. IgAN represents a persistent share of histologically confirmed GN-attributable KF; with no improvements in IgAN prevalence over time, these findings underscore the potential impact of emerging IgAN-specific therapies in reducing progression to KF.
Figure 1. IgAN and GN as a cause of kidney failure by histologic confirmation status, DOPPS region, and phase
Funding
- Commercial Support – Otsuka