What does this research mean for the field?

In patients with Immunoglobulin A nephropathy, immunosuppressive therapy does not significantly improve renal outcomes compared to supportive care alone, but is associated with a significantly higher rate of adverse events. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

This study aims to evaluate the clinical and histopathological profile of IgAN and analyze treatment outcomes.

June 19, 2026Open Access

Clinical, Histopathological Profile and Treatment Outcomes of Immunoglobulin A Nephropathy: A Single-center Retrospective Study from South India

Key Points

This study aims to evaluate the clinical and histopathological profile of IgAN and analyze treatment outcomes.
Conducted a retrospective observational study of 86 patients with biopsy-proven primary IgAN from 2005 to 2021.
Categorized patients based on syndromic presentations and treatment groups: supportive care, glucocorticoids, immunosuppressive combinations, and mycophenolate-based.
Histopathology graded using Oxford MEST-C score and statistical analyses performed using SPSS 22.0.
50% of patients achieved complete remission (CR) with no significant difference observed in outcomes between treatment groups (P=0.254).
34.9% of patients progressed to end-stage renal disease, while 15% exhibited partial or stable outcomes.
Adverse events were significantly higher in immunosuppressive groups than in supportive care (P=0.031).

Abstract

A BSTRACT Background: Immunoglobulin A nephropathy (IgAN) is the most common primary glomerulonephritis worldwide, with variable clinical presentations and outcomes. Treatment approaches remain heterogeneous due to the lack of uniform risk stratification and inconsistent response to immunosuppression. This study aimed to evaluate the clinical and histopathological spectrum of IgAN and analyze outcomes in relation to different treatment regimens. Materials and Methods: A retrospective observational study was conducted on 86 patients with biopsy-proven primary IgAN at a tertiary care center in south India (2005–2021). Patients were categorized into four syndromic presentations and four treatment groups: supportive care, glucocorticoids alone, glucocorticoids with cyclophosphamide/azathioprine, and mycophenolate-based regimens. Outcomes were defined as complete remission (CR), partial remission, stable renal function (non progressors) and progressive kidney disease. Histopathology was graded using the Oxford MEST-C score. Statistical analyses were performed using SPSS 22.0. Results: Mean age at presentation was 32.56 ± 12.39 years, 69.8% were males. The most common clinical presentation was nephritic syndrome (52.3%). Segmental sclerosis (64%) and tubular atrophy (T1/T2: 57%) were common histopathological findings. Fifty percent of patients achieved CR, 34.9% progressed to end-stage renal disease, and 15% had partial or stable outcomes. There was no statistically significant difference in outcomes between the treatment groups ( P = 0.254). Adverse events were significantly higher in immunosuppressive groups compared to supportive care ( P = 0.031). Conclusion: IgAN exhibits significant clinical and histopathological heterogeneity. Immunosuppressive therapy did not confer a statistically significant benefit over supportive care in our study but was associated with higher adverse events. Risk stratification based on clinical syndrome and histology may help guide personalized treatment decisions.

Clinical, Histopathological Profile and Treatment Outcomes of Immunoglobulin A Nephropathy: A Single-center Retrospective Study from South India

Key Points

Abstract

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