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Association Between Relapse and Long-Term Kidney Outcomes in IgA Nephropathy
Xue Shen1,2,3,4, Pei Chen1,2,3,4, Miao Hui1,2,3,4,5
1Renal Division, Department of Medicine, Peking University First Hospital, Beijing, China.
Kidney Medicine
|November 10, 2025
Summary
Relapse is common in IgA nephropathy (IgAN) after remission, increasing kidney disease progression. Controlling proteinuria below 0.3 g/d at remission significantly reduces relapse risk.
Area of Science:
- Nephrology
- Immunology
- Clinical Research
Background:
- IgA nephropathy (IgAN) relapse post-remission is under-researched.
- Understanding relapse incidence and risk factors is crucial for patient outcomes.
Purpose of the Study:
- Investigate IgAN relapse incidence in a prospective cohort.
- Assess the association between relapse and adverse kidney outcomes.
- Identify clinicopathological predictors of IgAN relapse.
Main Methods:
- Prospective cohort study of 1,069 IgAN patients in remission.
- Cox regression and LASSO Cox regression analyzed relapse predictors.
- Outcomes included end-stage kidney disease or 50% eGFR decline.
Main Results:
- 33% of patients experienced relapse.
- Relapse significantly increased kidney endpoint events and accelerated eGFR decline.
- Corticosteroid-induced remission was linked to higher early relapse; proteinuria <0.3 g/d at remission improved relapse-free rates.
Conclusions:
- IgAN relapse is prevalent and associated with worse kidney outcomes.
- Clinicopathological factors and medications predict relapse.
- Strict proteinuria control (<0.3 g/d) at remission is key to reducing relapse.
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