Initial proteinuria reduction and adverse kidney outcomes in IgA nephropathy: An analysis from the J-IGACS Article Swipe
Takaya Sasaki
,
Nobuo Tsuboi
,
Kentaro Koike
,
Hiroyuki Ueda
,
Masahiro Okabe
,
Shinya Yokote
,
Akihiro Shimizu
,
Keita Hirano
,
Tetsuya Kawamura
,
Takashi Yokoo
,
Yusuke Suzuki
·
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.1101/2025.06.15.25329622
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.1101/2025.06.15.25329622
Background Proteinuria reduction is considered a potential surrogate endpoint predictive of reflecting long-term kidney prognosis in IgA nephropathy (IgAN). However, its association with adverse kidney outcomes and IgAN-related decline in estimated glomerular filtration rate (eGFR) remains uncertain. Methods Patients with biopsy-proven IgAN from the Japan IgA Nephropathy Cohort Study (J-IGACS) were analyzed. Participants were categorized into tertiles based on their 12-month proteinuria-to-baseline proteinuria ratios. The primary outcome was a composite of ≥40% eGFR decline or initiation of kidney-replacement therapy. Associations between proteinuria ratio and outcomes were assessed using Cox proportional hazards models and restricted cubic splines. Multivariable analyses adjusted for age, sex, baseline eGFR, log-transformed proteinuria, Oxford classification scores, and use of corticosteroids and renin-angiotensin-aldosterone system inhibitors within 12 months. Results Among 793 patients, those in the lowest tertile (greatest proteinuria reduction) had significantly lower risk of the primary endpoint (P for trend <0.001) and a more favorable eGFR slope. Spline analysis showed a continuous, dose-response association between proteinuria ratio and improved outcomes. These findings remained robust in sensitivity analyses restricted to patients likely qualifying for clinical trials. The results showed that patients with lower proteinuria ratios tended to have slower rates of eGFR decline (P for trend <0.001), even after multivariable adjustment. Conclusion Proteinuria reduction within the first-year post-diagnosis is independently associated with lower risk of adverse kidney outcomes and a slower decline in kidney function in patients with IgAN. These results support the use of proteinuria reduction as a surrogate endpoint in both clinical trials and disease management.
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Metadata
- Type
- preprint
- Language
- en
- Landing Page
- https://doi.org/10.1101/2025.06.15.25329622
- https://www.medrxiv.org/content/medrxiv/early/2025/06/16/2025.06.15.25329622.full.pdf
- OA Status
- green
- References
- 26
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4411388871
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4411388871Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1101/2025.06.15.25329622Digital Object Identifier
- Title
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Initial proteinuria reduction and adverse kidney outcomes in IgA nephropathy: An analysis from the J-IGACSWork title
- Type
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preprintOpenAlex work type
- Language
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enPrimary language
- Publication year
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2025Year of publication
- Publication date
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2025-06-16Full publication date if available
- Authors
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Takaya Sasaki, Nobuo Tsuboi, Kentaro Koike, Hiroyuki Ueda, Masahiro Okabe, Shinya Yokote, Akihiro Shimizu, Keita Hirano, Tetsuya Kawamura, Takashi Yokoo, Yusuke SuzukiList of authors in order
- Landing page
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https://doi.org/10.1101/2025.06.15.25329622Publisher landing page
- PDF URL
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https://www.medrxiv.org/content/medrxiv/early/2025/06/16/2025.06.15.25329622.full.pdfDirect link to full text PDF
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YesWhether a free full text is available
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greenOpen access status per OpenAlex
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https://www.medrxiv.org/content/medrxiv/early/2025/06/16/2025.06.15.25329622.full.pdfDirect OA link when available
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Proteinuria, Nephropathy, Medicine, Cohort, Adverse effect, Internal medicine, Kidney, Urology, Gastroenterology, Endocrinology, Diabetes mellitusTop concepts (fields/topics) attached by OpenAlex
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0Total citation count in OpenAlex
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26Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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