See the source

Watch how IgA nephropathy primarily originates in the Peyer’s patches of the ileum.1

kidney disease iga nephropathy

Half of patients with IgA nephropathy may progress to end-stage renal disease (ESRD).2,3

IgA=immunoglobulin A; IgAN=immunoglobulin A nephropathy; MOD=mechanism of disease.

References

1. Barratt J, Rovin BH, Cattran D, et al. Why target the gut to treat IgA nephropathy? Kidney Int Rep. 2020;5(20):1620-1624. doi:10.1016/j.ekir.2020.08.009

2. Hastings MC, Bursac Z, Julian BA, et al. Life expectancy for patients from the southeastern United States with IgA nephropathy. Kidney Int Rep. 2017;3(1):99-104. doi:10.1016/j.ekir.2017.08.008

3. Schena FP. A retrospective analysis of the natural history of primary IgA nephropathy worldwide. Am J Med. 1990;89(2):209-215. doi:10.1016/0002-9343(90)90300-3

4. Barratt J, Feehally J. Primary IgA nephropathy: new insights into pathogenesis. Semin Nephrol. 2011;31(4):349-360. doi:10.1016/j.semnephrol.2011.06.006

5. Archdeacon PA, Shaffer RN, Winkelmayer WC, Falk RJ, Roy-Chaudhury P. Fostering innovation, advancing patient safety: the kidney health initiative. Clin J Am Soc Nephrol. 2013;8(9):1609-1617. doi:10.2215/CJN.01140113

6. Kidney Disease: Improving Global Outcomes (KDIGO) Glomerulonephritis Work Group. KDIGO Clinical Practice Guideline for Glomerulonephritis. Kidney Int. 2012;2(suppl 2):259-274.

7. IgA Nephropathy Foundation of America, Inc. The Voice of the Patient: Externally Led Patient-Focused Drug Development Meeting on IgA Nephropathy. National Kidney Foundation; 2018.

8. Penfold RS, Prendecki M, McAdoo S, Tam FWK. Primary IgA nephropathy: current challenges and future prospects. Int J Nephrol Renovasc Dis. 2018;11:137-148. doi:10.2147/IJNRD.S129227

9. Arroyo AH, Bomback AS, Butler B, et al. Predictors of outcome for severe IgA nephropathy in a multi-ethnic U.S. cohort. Clin Nephrol. 2015;84(3):145-155. doi:10.5414/CN108556.

10. Rauen T, Wied S, Fitzner C, et al; for the STOP-IgAN Investigators. After 10 years of follow-up, no difference between supportive care plus immunosuppression and supportive care alone in IgA nephropathy. Kidney Int Supp.2020;98(4):1044-1052. doi:10.1016/j.kint.2020.04.046

11. Lafayette RA, Kelepouris E. Immunoglobulin A nephropathy: advances in understanding of pathogenesis and treatment. Am J Nephrol. 2018;47(suppl 1):43-52. doi:10.1159/000481636

12. United States Renal Data System (USRDS). 2018 USRDS Annual Data Report. Vol 2. 2018; chap 9. Accessed April 7, 2021. https://usrds.org/media/1734/v2_c09_esrd_costs_18_usrds.pdf.

13. Golestaneh L, Alvarez PJ, Reaven N, et al. All-cause costs increase exponentially with increased chronic kidney disease stage. Am J Manag Care. 2017;23(10 Suppl):S163-S172.

14. Knoop T, Vikse BE, Svarstad E, Leh S, Reisæter AV, Bjørneklett R. Mortality in patients with IgA nephropathy. Am J Kidney Dis. 2013;62(5):883-890. doi:10.1053/j.ajkd.2013.04.019

15. Ponticelli C, Glassock RJ. Posttransplant recurrence of primary glomerulonephritis. Clin J Am Soc Nephrol. 2010;5(12):2363-2372. doi:10.2215/CJN.06720810

16. Ponticelli C, Traversi L, Banfi G. Renal transplantation in patients with IgA mesangial glomerulonephritis. Pediatr Transplantat. 2004:8(4):334-338. doi:10.1111/j.1399-3046.2004.00177.x

17. He J-W, Zhou X-J, Lv J-C, Zhang H. Perspectives on how mucosal immune responses, infections and gut microbiome shape IgA nephropathy and future therapies. Theranostics. 2020;10(25):11462-11478. doi:10.7150/thno.49778

18. Cheung CK, Barratt J. Pathogenesis of IgA nephropathy. 2020. Accessed April 7, 2021. https://www.uptodate.com/contents/pathogenesis-of-iga-nephropathy?search=pathogenesis%20of%20iga%20nephropathy&source=search_result&selectedTitle=1~126&usage_type=default&display_rank=1.

19. Reinholdt J, Husby S. IgA and mucosal homeostasis. In: Morteau O, ed. Oral Tolerance: The Response of the Intestinal Mucosa to Dietary Antigens. Landes Bioscience; 2003.

20. Floege J. Fatal attraction: immunoglobulin A and the glomerular mesangium. J Am Soc Nephrol. 2019;30(7):1139-1141. doi:10.1681/ASN.2019040373

21. Fellström BC, Barratt J, Cook H, et al. Targeted-release budesonide versus placebo in patients with IgA nephropathy (NEFIGAN): a double-blind, randomised, placebo-controlled phase 2b trial. Lancet. 2017;390(10084):2117-2127. doi:10.1016/S0140-6736(17)30550-0

22. Yeo SE, Liew A, Barratt J. Emerging therapies in immunoglobulin A nephropathy. Nephrology (Carlton). 2015;20(11):788-800. doi:10.1111/nep.12527

23. Wehbi B, Oblet C, Boyer F, et al. Mesangial deposition can strongly involve innate-like IgA molecules lacking affinity maturation. J Am Soc Nephrol. 2019;30(7):1238-1249. doi:10.1681/ASN.2018111089

24. Thompson A, Carroll K, Inker LA, et al. Proteinuria reduction as a surrogate end point in trials of IgA nephropathy. Clin J Am Soc Nephrol. 2019;14(3):469-481. doi:10.2215/CJN.08600718

25. Ibrahim A, Garg AX, Knoll GA, Akbari A, White CA. Kidney function endpoints in kidney transplant trials: a struggle for power. Am J Transplant. 2013;13(3):708-713. doi:10.1111/ajt.12050

26. Levey AS, Gansevoort RT, Coresh J, et al. Change in albuminuria and GFR as end points for clinical trials in early stages of CKD: a scientific workshop sponsored by the National Kidney Foundation in collaboration with the US Food and Drug Administration and European Medicines Agency. Am J Kidney Dis. 2020;75(1):84-104. doi:10.1053/j.ajkd.2019.06.009

27. Goto M, Wakai K, Kawamura T, Ando M, Endoh M, Tomino Y. A scoring system to predict renal outcome in IgA nephropathy: a nationwide 10-year prospective cohort study. Nephrol Dial Transplant. 2009;24(10):3068-3074. doi:10.1093/ndt/gfp273

28. Brantsma AH, Atthobari J, Bakker SJ, de Zeeuw D, de Jong PE, Gansevoort RT. What predicts progression and regression of urinary albumin excretion in the nondiabetic population? J Am Soc Nephrol. 2007;18(2):637-645. doi:10.1681/ASN.2006070738

29. Cravedi P, Remuzzi G. Pathophysiology of proteinuria and its value as an outcome measure in chronic kidney disease. Br J Clin Pharmacol. 2013;76(4):516-523. doi:10.1111/bcp.12104

30. Cattran DC, Coppo R, Cook HT, et al. The Oxford classification of IgA nephropathy: rationale, clinicopathological correlations, and classification. Kidney Int. 2009;76(5):534-545. doi:10.1038/ki.2009.243