Abstract: FR-PO0848
Effect of Different Stages of Cardiovascular-Kidney-Metabolic Syndrome on the Prognosis of Patients with IgA Nephropathy
Session Information
- Glomerular Diseases: Practice and New Concepts Shaping Modern Care
October 23, 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
- Zhang, Sen, Department of Nephrology, General Hospital of Ningxia Medical College, Yinchuan, China
- Zhou, Xiaoling, Department of Nephrology, People’s Hospital of Ningxia Hui Autonomous Region, Yinchuan, China
Background
In 2023, the American Heart Association introduced the Cardiovascular-Kidney-Metabolism (CKM) syndrome to integrate interactions among metabolic abnormalities, chronic kidney disease, and cardiovascular disease. However, the distribution and prognostic value of CKM stages in IgA nephropathy (IgAN) remain unclear. This study aimed to evaluate the impact of different CKM stages on IgAN prognosis.
Methods
This retrospective study included patients with biopsy-proven primary IgAN at the Department of Nephrology of our Hospital (August 2008-October 2024). After applying inclusion/exclusion criteria, 1,236 patients were enrolled and classified into four CKM stages: no metabolic/cardiovascular disease (CKM 0-2a), CKM 2b, CKM 3, and CKM 4. Baseline clinical and pathological characteristics were compared. Survival was analyzed by Kaplan-Meier method, and independent risk factors were identified using Cox regression.
Results
Among 1,236 patients (52.8% male, mean age 38.97±12.47 years), the CKM stage distribution was: 310 (25.1%) in CKM 0-2a, 582 (47.1%) in CKM 2b, 289 (23.4%) in CKM 3, and 55 (4.4%) in CKM 4. With advancing CKM stage, patients were older, had higher blood pressure, worse metabolic profiles, and progressive renal dysfunction. Notably, CKM stage 3 patients had the highest serum creatinine and 24-hour urine protein, lowest eGFR, and 42.6% had Lee grade IV-V lesions.
Over a median follow-up of 80.18 months, 335 patients (27.1%) reached endpoint events. Renal outcome incidence was highest in stage 3 (52.6%), cardiovascular event was highest in stage 4 (3.64%). Survival analysis showed significantly lower cumulative survival rates for CKM stages 3 and 4 compared with lower stages. Multivariate Cox regression identified CKM stage 3 (HR=2.13, 95% CI 1.16-3.12), CKM stage 4 (HR=2.23, 95% CI 1.18-4.21), Lee grade IV and V, 24-hour urine protein, mean arterial pressure, serum phosphorus, and TyG index as independent risk factors for poor prognosis, hemoglobin was a protective factor.
Conclusion
Approximately 75% of IgAN patients are at CKM stage 2b or higher. The CKM staging independently predicts IgAN prognosis. Stage 3 is the main driver of adverse renal outcomes, whereas stage 4 increases cardiovascular burden. Incorporating CKM staging into IgAN risk assessment may facilitate early identification of high-risk patients and guide comprehensive metabolic management.