Abstract: TH-PO0510
Changes in Clinical and Biopsy Characteristics of Patients Diagnosed with IgAN over 12 Years: A Single-Center Study
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
- Ramos, Kristina A., Lenox Hill Hospital, New York, New York, United States
- Patel, Anuj A., Lenox Hill Hospital, New York, New York, United States
- Rosenstock, Jordan L., Lenox Hill Hospital, New York, New York, United States
Background
The management of IgA nephropathy (IgAN) is rapidly evolving, but it is unknown whether patients are being identified earlier in the disease course in the modern treatment era. We hypothesized that recent years may be associated with changes in clinical characteristics and biopsy findings of those diagnosed with IgAN reflecting changes in biopsy practices. To test this, we compared clinical and pathologic features of IgAN across two time periods spanning over a decade.
Methods
We conducted a retrospective cohort study of adults with biopsy-proven IgAN at a single tertiary center between 2014 and 2026. Patients were stratified into early (2014-2021) and late (2022-2026) cohorts. The year 2022 was selected to reflect adoption of newer therapies, including SGLT2 inhibitors and targeted-release budesonide following FDA approval in 2021. Baseline data included age, sex, hematuria, proteinuria, serum creatinine, eGFR by CKD-EPI, and Oxford MEST-C classification. Comparisons were performed using t-tests and chi-square tests.
Results
A total of 26 patients in the early cohort (2016–2021) and 31 in the late cohort (2022–early 2026) were included. Baseline age (43.2 vs 41.2 years, p=0.60) and sex distribution (male 65% vs 61%, p=0.33) were similar. Hematuria was present in 81% vs 71% (p=0.18). Mean proteinuria was comparable (1.87 vs 1.79 g/g, p=0.85), with no difference in proportion of patients with proteinuria <1 gram (35% vs 35%, p=0.28).
Kidney function at diagnosis was significantly higher in the late cohort (eGFR 74.6 vs 55.2 mL/min, p=0.024), with a trend toward lower serum creatinine (1.40 vs 1.85 mg/dL, p=0.057). On histopathology, there were no differences in M (p=0.28), S (p=0.39), or C lesions (p=0.31). However, the late cohort had a higher prevalence of endocapillary hypercellularity (E1: 43% vs 15%, p=0.006) and significantly fewer chronic lesions (T1/T2: 37% vs 77%, p<0.001).
Conclusion
Compared with the prior 8 years, patients diagnosed with IgAN in the most recent 4 years presented with better kidney function, increased histologic activity, and markedly reduced chronicity at biopsy. These findings may suggest a temporal shift toward earlier disease recognition in the contemporary treatment era, perhaps reflecting evolving biopsy practices due to expanded therapeutic options. However, there were no differences in hematuria and proteinuria.