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IgA Nephropathy in the Elderly.

Dana V Rizk1, Emily Dryer1,2, Ashutosh Tamhane1

  • 1Division of Nephrology, Department of Medicine, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.

Kidney International Reports
|August 15, 2025
PubMed
Summary
This summary is machine-generated.

IgA nephropathy (IgAN) in elderly patients presents severely and has a poor prognosis. Older adults diagnosed with IgAN face a high risk of kidney failure and death.

Keywords:
IgA nephropathyIgANelderlykidney failuremortality

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Area of Science:

  • Nephrology
  • Geriatric Medicine
  • Immunology

Background:

  • Limited knowledge exists regarding the clinical presentation and prognosis of IgA nephropathy (IgAN) in elderly patients.
  • IgAN is a common primary glomerulonephritis, but its impact on older populations requires further investigation.

Purpose of the Study:

  • To assess the clinical and histologic findings in patients aged 60 years or older at the time of IgAN diagnosis.
  • To examine factors associated with the risk of kidney failure and death in this elderly cohort.

Main Methods:

  • A retrospective analysis of 127 elderly patients diagnosed with IgAN between 1996 and 2020.
  • Clinical data, including estimated glomerular filtration rate (eGFR) and proteinuria, along with histologic MEST-C classification, were collected. Outcomes of kidney failure and death were ascertained using the USRDS and NDI.
  • Cause-specific Cox hazards regression and standard Cox proportional hazards regression were used to analyze predictors of kidney failure and mortality.

Main Results:

  • Elderly IgAN patients presented with a median eGFR of 25 ml/min/1.73 m², with 81% having significant proteinuria.
  • Forty-five patients progressed to kidney failure (median time 11.3 years) and 86 died (median time 7.5 years).
  • Male sex, advanced CKD stages (3-5) at diagnosis, increasing age, and advanced CKD were associated with higher risks of kidney failure and mortality.

Conclusions:

  • IgA nephropathy diagnosed in elderly individuals is characterized by a severe clinical phenotype.
  • Elderly patients with IgAN face a poor prognosis, with a substantial risk of kidney failure and premature death.