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Correlation of foot process effacement with clinicopathological features and short-term prognosis in IgA nephropathy

Yu Wang1, Yang Yang1, Xiaoli Wen1

  • 1Department of Nephrology, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China.

Annals of Medicine
|May 20, 2026
PubMed
Abstract

Insights

Foot process effacement (FPE) severity in IgA nephropathy (IgAN) correlates with worse kidney function and higher risk of poor outcomes. Severe FPE independently predicts worse short-term renal outcomes in IgAN patients.

Area of Science:

  • Nephrology
  • Pathology
  • Clinical Medicine

Background:

  • IgA nephropathy (IgAN) is a common primary glomerulonephritis.
  • Foot process effacement (FPE) is a key pathological feature in IgAN.
  • The clinical significance of varying FPE degrees requires further elucidation.

Purpose of the Study:

  • To compare clinicopathological characteristics of IgAN patients with different degrees of FPE.
  • To evaluate the association between FPE severity and short-term renal outcomes in IgAN.

Main Methods:

  • Retrospective analysis of 1,001 biopsy-proven IgAN patients categorized by FPE severity (mild, moderate, severe).
  • Clinical and pathological data were analyzed using regression models.
  • Short-term renal outcomes (1-year follow-up) were assessed using overlap weighting, Cox regression, and Kaplan-Meier analysis.

Main Results:

  • Higher FPE severity correlated with increased blood pressure, proteinuria, anemia, and decreased eGFR and albumin.
  • Worsening FPE was associated with advanced mesangial hyperplasia and tubulointerstitial damage.
  • Severe FPE was linked to higher serum phosphorus, endocapillary hypercellularity, and interstitial fibrosis, with significantly lower remission rates.

Conclusions:

  • FPE degree in IgAN is significantly correlated with proteinuria, hypoalbuminemia, eGFR decline, and interstitial fibrosis.
  • Severe FPE is an independent risk factor impacting short-term renal outcomes in IgAN patients.
Keywords:
IgA nephropathyfoot process effacementpodocyte

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