Abstract: SA-PO0631
Efficacy of Antiplatelet Therapy for IgAN in Nationwide Multicenter Prospective Cohort Study in Japan (JIGACS)
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
- Saito, Suguru, Department of Nephrology, Tokyo Medical University, Tokyo, Japan
- Moriyama, Takahito, Department of Nephrology, Tokyo Medical University, Tokyo, Japan
- Kanno, Yoshihiko, Department of Nephrology, Tokyo Medical University, Tokyo, Japan
- Yokoo, Takashi, Division of Nephrology and Hypertension, Department of Internal Medicine Tokyo Jikei, Tokyo, Japan
- Suzuki, Yusuke, Department of Nephrology, Juntendo University Faculty of Medicine, Tokyo, Japan
Background
Previously, antiplatelet agents (APA) are widely used to treat immunoglobulin A nephropathy (IgAN). However, KDIGO 2025 guideline for IgAN did not recommend APA, because of no evidence of efficacy. But the effect of antiplatelet therapy for preserving kidney function and reducing proteinuria in patients with IgAN remains controversial. In this study, we evaluated the effects of APA in IgAN by analyzing data from a nationwide, multicenter, prospective cohort study in Japan (JIGACS).
Methods
From 1030 IgAN patients, we selected 838 adult IgAN patients with CKD stage 1-4, confirming to be treated by APA or not during follow up period. We analyzed the remission rate of proteinuria, hematuria and both (clinical remission: CR) between APA group and non-APA group after choosing patients with treated conservative therapy alone (Study 1), and the renal prognosis until progression to end stage kidney disease (ESKD) and 50% increase of creatinine between APA group and non-APA group after matching clinical and histological characteristics and treatments between groups in all patients (Study 2) by the Kaplan-Meier analysis with log-rank test and the univariate and multivariate Cox regression analysis.
Results
In Study 1, 71 patients in APA group and 85 patients in non-APA group were chosen, in Study 2, 312 patients in each group were selected, and all backgrounds were similar between both groups in both studies. In study 1, the 10-year cumulative remission rate of proteinuria (APA vs. non-APA: 71.1 vs. 57.4 %, p=0.406), hematuria (78.9 vs. 77.3 %, p=0.998), and CR (58.8 vs. 46.7 %, p=0.248) were similar between both groups, and APA was not significant factor for proteinuria (hazard ratio (HR): 1.28, 95% confidence interval (CI) 0.79-2.13, p=0.349), hematuria (HR: 0.422, 95%CI 0.75-2.00, p=0.422), and CR (HR: 1.78, 95%CI 0.96-3.28, p=0.066). In study 2, the 10-year cumulative renal survival rate was also similar between both groups (APA vs. non-APA: 82.1 vs. 89.6%, p=0.307), and APA was not significant factor for renal survival (HR: 0.95, 0.53-1.72, p=0.669).
Conclusion
Our findings indicate that antiplatelet therapy does not provide reno-protective benefits to reduce hematuria and proteinuria and prevent progression to ESKD in patients with IgAN. Our results from JGACS support the recommendation not to use antiplatelet agents for IgAN in KDIGO guideline 2025.