Kidney Week

Abstract: SA-PO0668

Epidemiology and Prognostic Determinants of IgAN in Apulia, Southern Italy

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

• Di Leo, Vincenzo, Universita degli Studi di Bari Aldo Moro, Bari, Apulia, Italy

Vincenzo Di Leo, MD

• Papadia, Federica, Universita degli Studi di Bari Aldo Moro, Bari, Apulia, Italy

Federica Papadia, DrMed, MEd

• Ferrulli, Roberta, Universita degli Studi di Bari Aldo Moro, Bari, Apulia, Italy

Roberta Ferrulli, DrMed

• Rampino, Sabrina, Universita degli Studi di Bari Aldo Moro, Bari, Apulia, Italy

Sabrina Rampino

• Cristello, Erika, Universita degli Studi di Bari Aldo Moro, Bari, Apulia, Italy

Erika Cristello, MD

• Annese, Francesca, Universita degli Studi di Bari Aldo Moro, Bari, Apulia, Italy

Francesca Annese, MD

• Montinaro, Adriano, Universita degli Studi di Bari Aldo Moro, Bari, Apulia, Italy

Adriano Montinaro, MD

• Giliberti, Marica, Universita degli Studi di Bari Aldo Moro, Bari, Apulia, Italy

Marica Giliberti, MD

• Giannuzzi, Francesca, Universita degli Studi di Bari Aldo Moro, Bari, Apulia, Italy

Francesca Giannuzzi, MS, MSc

• Sallustio, Fabio, Universita degli Studi di Bari Aldo Moro, Bari, Apulia, Italy

Fabio Sallustio, PhD

• Fiorentino, Marco, Universita degli Studi di Bari Aldo Moro, Bari, Apulia, Italy

Marco Fiorentino, MD, PhD

• Schena, Francesco Paolo, Universita degli Studi di Bari Aldo Moro, Bari, Apulia, Italy

Francesco Paolo Schena, MD, FASN

• Rossini, Michele, Universita degli Studi di Bari Aldo Moro, Bari, Apulia, Italy

Michele Rossini

• Gesualdo, Loreto, Universita degli Studi di Bari Aldo Moro, Bari, Apulia, Italy

Loreto Gesualdo, DrMed

Background

IgAN is the most common primary glomerulonephritis worldwide, although its epidemiology remains incompletely defined because most available data derive from biopsy-based registries influenced by regional practices and healthcare access.

Methods

We conducted a retrospective epidemiological study including 860 patients with biopsy-proven IgAN residing in Apulia (Southern Italy) who underwent native kidney biopsy between 2003 and 2024. Incidence was calculated as newly diagnosed cases relative to the regional population, while prevalence was estimated assuming a median disease duration of 33.5 years. The composite endpoint included dialysis, kidney transplantation or death. Outcome-free survival was assessed using Kaplan–Meier analysis and prognostic factors were evaluated using Cox regression models.

Results

The mean annual incidence of IgAN was 0.97 per 100,000 inhabitants/year (95% CI 0.8–1.6) and the estimated prevalence was 3.25 per 10,000 inhabitants (95% CI 2.68–5.36) over the entire study period, increasing to 1.17 per 100,000 inhabitants/year (95% CI 0.86–1.56) and to 3.92 per 10,000 inhabitants (95% CI 2.88–5.23), respectively, in the most recent years (2019–2024). During follow-up, 17.7% of patients experienced a critical event. Kaplan–Meier analysis showed outcome-free survival above 65% at approximately 20 years. In multivariate analysis, proteinuria >1 g/day (aHR 3.72, 95% CI 1.83-7.56), higher serum creatinine (aHR 1.81, 95% CI 1.60-2.03), tubulointerstitial damage (T1 vs T0 aHR 2.21, 95% CI 1.46-3.35; T2 vs T0 aHR 1.95, 95% CI 1.10-3.46) and severe arteriolar hyalinosis (grade 2 vs grade 0 aHR 2.20, 95% CI 1.29-3.37; grade 3 vs grade 0 aHR 2.94, 95% CI 1.46-5.93) were independently associated with adverse outcomes.

Conclusion

IgAN in Apulia shows incidence and prevalence comparable with other European populations. Baseline proteinuria, renal function and chronic histological lesions are major predictors of progression.

Figure 1. A Kaplan-Meier outcomes-free survival estimate. B Kaplan–Meier outcomes-free survival by age and by proteinuria