Abstract: SA-PO0648
A Retrospective Study of IgAN from a Single Academic Center
Session Information
- Glomerular Diseases: Clinical, Outcomes, and Therapeutics Research - Other
October 24, 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
- Shim, Curie, Thomas Jefferson University Sidney Kimmel Medical College, Philadelphia, Pennsylvania, United States
- Akram, Fatima, Thomas Jefferson University Sidney Kimmel Medical College, Philadelphia, Pennsylvania, United States
- Verma, Yogesh, Thomas Jefferson University Sidney Kimmel Medical College, Philadelphia, Pennsylvania, United States
- Gulati, Rakesh, Thomas Jefferson University Sidney Kimmel Medical College, Philadelphia, Pennsylvania, United States
- Arif, Hasan, Thomas Jefferson University Sidney Kimmel Medical College, Philadelphia, Pennsylvania, United States
- Shenoy, Prashamsa, Thomas Jefferson University Sidney Kimmel Medical College, Philadelphia, Pennsylvania, United States
- Gupta, Maitreyee M., Thomas Jefferson University Sidney Kimmel Medical College, Philadelphia, Pennsylvania, United States
- Le, Dustin, Thomas Jefferson University Sidney Kimmel Medical College, Philadelphia, Pennsylvania, United States
- Zhang, JingJing, Thomas Jefferson University Sidney Kimmel Medical College, Philadelphia, Pennsylvania, United States
Background
IgA nephropathy is a common glomerular disease, and even patients with proteinuria levels <0.50 g/g can develop kidney failure within a decade. We aimed to summarize patient outcomes to assess our center’s practices related to biopsy timing, initiation of immunosuppressant therapy, and clinical outcomes, including progression to end-stage renal disease.
Methods
We manually reviewed the electronic health records of patients with an ICD diagnosis of IgA nephropathy who were seen in the nephrology outpatient clinic from January 1 2008 to December 31 2025. We then restricted the analysis to patients seen prior to 2021 to ensure adequate follow-up time.
Results
We identified 108 patients with biopsy-proven IgA nephropathy. Among these, 43 were diagnosed between 2021 and 2025, 31 between 2016 and 2020, and 34 between 2008 and 2015. Of the 65 patients seen before 2021, 15 patients were excluded due to inadequate follow-up time or secondary IgA, etc. Of the remaining 50 patients, 10 (20%) reached end-stage renal disease (ESRD). The average age of these patients at diagnosis was 54 years, with an average time of progression to ESRD of 6.7 years. Notably, 5 of these 10 patients progressed to ESRD within 5 years of their first kidney biopsy (average 2.8 years); of these 5, 4 were older than 67 years at diagnosis. In comparison, the patients who progressed to ESRD after 5 years were about 45 years old at diagnosis, with an average time to ESRD progression of 10.6 years. The average proteinuria quantification was 4103.7 mg/g, except for one patient who had 2+ proteinuria on urinalysis but no quantification available. The mean serum creatinine level was 2.08 mg/dL at the time of kidney biopsy. All patients presented with hematuria. Six of the 10 patients who reached ESRD have received a kidney transplant.
Conclusion
Some patients with IgA nephropathy (IgAN) will progress to end-stage renal disease (ESRD) within 10 years. In addition to proteinuria, other factors may contribute to rapid progression, including hypertension and pathological changes. Our study showed that older age at diagnosis was associated with faster progression. This phenomenon raises the hypothesis of delayed diagnosis as the reason for poor outcome in older patients, suggesting that a low threshold for kidney biopsy should be maintained when IgA nephropathy is suspected. Further studies are needed to obtain evidence to guide clinical practice.