IgAN explained
DISEASE PROGRESSION
IgA nephropathy (IgAN) has a variable but progressive clinical course, which can negatively impact patients’ quality of life (QoL)1–5
The clinical presentation of IgAN and the risk and rate of progression to end-stage kidney disease (ESKD) is highly variable between patients1–4
Patients may present with:1–5
High proteinuria
Macrohematuria
Renal insufficiency
Hypertension
Acute kidney injury
Edema
Kidney biopsy is essential for confirmation of diagnosis in IgAN and to guide subsequent clinical care decisions2,6
Similarly, the rate at which patients progress through different stages of IgAN to kidney failure can be highly variable7–11
Up to 53% of patients
progress to ESKD within 20 years of an IgAN diagnosis7–9*
In a population-based cohort study (N=3622), patients with IgAN were found to have a:10
53% increased risk of mortality compared to matched controls
6-year reduction in life expectancy compared to matched controls
Variation in clinical course and outcomes leads to delayed diagnosis in patients presenting with established kidney disease.2,11
Patients’ health-related QoL is affected at all stages of IgAN2,9
Diagnosis
Patients may be asymptomatic or may experience:2,9
- Fatigue
- Frequent episodes of hematuria
- Hypertension
- Foamy urine
- Edema
Mid-stage
The impact of receiving an IgAN diagnosis and the variable progression towards ESKD may leave patients feeling:2,9,12
- Depressed
- Anxious
- Afraid due to the uncertainty and complications of therapy
- Emotionally distressed from lack of counseling
Late-stage (ESKD)
Progression to kidney failure may cause mental and physical symptoms such as:2,9
- Depressed
- Sexual dysfunction
- Fatigue
- Weakness
- Insomnia
- Anorexia
- Dysgeusia
- Nausea
- Muscle cramps
- Pruritus
- Bone pain and fractures
- Cognitive dysfunction
- Visual disturbances
- Neuropathy
Patients at all stages of IgAN experience symptoms that lower their QoL
References & footnotes
Footnotes
*Studies used were a population-based cohort study of patients in Southern China with IgAN (N=619), a population-based cohort study of patients from the Southeastern United States (N=251) and a systemic literature review on 123 epidemiologic studies7–9
Abbreviations
ESKD, end-stage kidney disease; IgA, immunoglobulin A; IgAN, IgA nephropathy; QoL, quality of life.
References
- Wyatt R, Julian B. IgA Nephropathy. N Engl J Med. 2013; 368:2402–z.
- Lai KN, et al. IgA nephropathy. Nat Rev Dis Primers. 2016; 2:16001.
- Penfold RS, et al. Primary IgA nephropathy: current challenges and future prospects. Int J Nephrol Renovasc Dis. 2018; 11:137–48.
- Rodrigues JC, et al. CJASN Glomerular Disease Education Series:IgA Nephropathy. Clin J Am Soc Nephrol. 2017; 12:677–86.
- Yeo SC, et al. Is immunoglobulin A nephropathy different in different ethnic populations? Nephrology. 2019; 24:885–95.
- Kidney Disease: Improving Global Outcomes (KDIGO) Glomerular Diseases Work Group. KDIGO 2021 Clinical Practice Guideline for the Management of Glomerular Diseases. Kidney Int. 2021; 100:S1−S276.
- Xie J, et al. Predicting Progression of IgA Nephropathy: New Clinical Progression Risk Score. PLoS One. 2012; 7:e38904.
- Hastings MC, et al. Life Expectancy for Patients From the Southeastern United States With IgA Nephropathy. Kidney Int Rep. 2018; 3:99–104.
- Kwon CS, et al. A Systematic Literature Review of the Epidemiology, Health-Related Quality of Life Impact, and Economic Burden of Immunoglobulin A Nephropathy. J Health Econ Outcomes Res. 2021; 8:36−45.
- Jarrick S, et al. Mortality in IgA Nephropathy: A Nationwide Population-Based Cohort Study. J Am Soc Nephrol. 2019; 30:866–76
- Lafayette RA, Kelepouris A. Immunoglobulin A Nephropathy: Advances in Understanding of Pathogenesis and Treatment. Am J Nephrol. 2018; 47 (sup1):S43–S52.
- Cheung A, et al. Executive summary of the KDIGO 2021 Clinical Practice Guideline for the Management of Blood Pressure in Chronic Kidney Disease. Kid Int. 2021; 99:559–69.
HQ-SPT-2500013 | Date of preparation: February 2025