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Related Experiment Video

Updated: Mar 21, 2026

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The Optimal Management Strategy for IGA Nephropathy Patients With Different Clinical Presentations.

Savas Ozturk1, Abdullah Sumnu2, Necmi Eren3

  • 1Istanbul Faculty of Medicine, Department of Nephrology, Istanbul University, Istanbul, Türkiye.

Nephrology (Carlton, Vic.)
|March 19, 2026
PubMed
Summary

Immunosuppressive therapies (IST) impact IgA nephropathy (IgAN) differently based on patient presentation. Asymptomatic urinary abnormality (AUA) patients showed better outcomes with less IST, while nephritic and nephrotic groups required more IST and progressed faster.

Keywords:
TSN‐GOLDTürkiyeepidemiologyglomerulonephritisoutcomeprimary glomerular diseases

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Area of Science:

  • Nephrology
  • Immunology
  • Clinical Medicine

Background:

  • IgA nephropathy (IgAN) treatment lacks consensus.
  • Investigating immunosuppressive therapies (IST) in diverse IgAN clinical presentations is crucial.

Purpose of the Study:

  • To evaluate the outcomes of IST in IgAN patients across different clinical phenotypes.
  • To identify factors influencing renal decline and remission rates.

Main Methods:

  • Retrospective cohort study using nationwide data from the TSN-GOLD Working Group.
  • Included 913 IgAN patients with ≥6 months follow-up.
  • Classified patients into asymptomatic urinary abnormality (AUA), nephritic syndrome, and nephrotic syndrome groups.

Main Results:

  • AUA group had lower IST use (38.3%) and higher remission rates (84.5%) compared to nephritic (55.2% IST, 76.8% remission) and nephrotic groups (65.1% IST, 77.3% remission).
  • Nephritic and nephrotic groups showed significantly shorter time to primary outcome (≥50% eGFR decline or ESRD) than AUA group.
  • IST was associated with reduced risk of primary outcome (HR=0.699).

Conclusions:

  • IST effectiveness varies with IgAN phenotype; AUA patients benefit from minimal IST, while nephritic/nephrotic groups require more intensive treatment.
  • Phenotype-tailored IST and long-term monitoring are recommended.
  • Standardized risk assessment using MEST-C criteria is needed for future studies.