IgAN explained
RISK PREDICTION
Identification of patients at a high risk of disease progression earlier may improve outcomes1,2
Sustained proteinuria of >1g/day is the strongest modifiable predictor of a high risk of kidney disease progression1–5
Reducing proteinuria:2–4
Slows disease progression
Extends average time to kidney failure
Patients with proteinuria >1g/day are at a high risk for progression to end-stage kidney disease (ESKD)2
The International Risk Prediction Tool for IgAN can help identify patients at high risk of disease progression6–8
International Risk Prediction Tool for IgAN can be used:7,8
The International Risk Prediction Tool for IgAN is recommended by the most recent KDIGO guidelines and uses a variety of clinical parameters to predict disease progression7,8
The MEST-C (mesangial and endocapillary hypercellularity, segmental sclerosis, interstitial fibrosis/tubular atrophy, and crescents) score is a histopathological scoring system for patients with IgAN. The MEST-C score should be determined at the time of biopsy and is an important practice point for the diagnosis of IgAN6
References & footnotes
Abbreviations
ESKD, end-stage kidney disease; IgA, immunoglobulin A; IgAN, IgA nephropathy; KDIGO, Kidney Disease: Improving Global Outcomes; MEST, mesangial and endocapillary hypercellularity, segmental sclerosis and interstitial fibrosis/tubular atrophy; MEST-C, Oxford classification MEST-C.
References
- Lai KN, et al. IgA nephropathy. Nat Rev Dis Primers. 2016; 2:16001.
- Reich HN, et al. Remission of Proteinuria Improves Prognosis in IgA Nephropathy. J Am Soc Nephrol. 2007; 18:3177–83.
- Inker LA, et al. Early change in urine protein as surrogate endpoint in studies of IgA Nephropathy: An individual patient meta-analysis. Am J Kidney Dis. 2016; 68:392–401.
- Thompson A, et al. Proteinuria Reduction as a Surrogate End Point in Trials of IgA Nephropathy. Clin J Am Soc Nephrol. 2019; 14:469–481.
- Le WB, et al. Long-term renal survival and related risk factors in patients with IgA nephropathy: results from a cohort of 1155 cases in a Chinese adult population. Nephrol Dial Transplant. 2012; 27:1479–85.
- 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.
- Barbour SJ, et al. Evaluating a New International Risk-Prediction Tool in IgA Nephropathy. JAMA Intern Med. 2019; 179:942–52.
- Barbour SJ, et al. Application of the International IgA Nephropathy Prediction Tool one or two years post-biopsy. Kid Int. 2022; 102:160–72.
- Haaskjold, YL, et al. Validation of two IgA nephropathy risk-prediction tools using a cohort with a long follow-up. Neph Dial Trans. 2022;0:1–9.
HQ-SPT-2500014 | Date of preparation: February 2025