COMPARISON OF THE CLINICAL PROFILE OF IGA NEPHROPATHY WITH OTHER PRIMARY GLOMERULONEPHRITIS IN NEPALESE PATIENTS UNDERGOING NATIVE KIDNEY BIOPSY

8 Feb 2025 12 a.m. 12 a.m.

WCN25-AB-2592, Poster Board= SAT-543

Introduction:

Glomerular diseases contribute significantly to the global burden of kidney disease and end-stage renal disease (ESRD). Despite being the most common primary glomerular disease, particularly in Asia, IgA Nephropathy (IgAN) remains poorly understood in terms of its clinical presentation and treatment.

Methods:

This observational study, conducted at Tribhuvan University Teaching Hospital between May 2022 and April 2023, aimed to evaluate the spectrum of histopathological diagnoses in patients undergoing native kidney biopsies for glomerular diseases. The study specifically focused on comparing the clinical profile of IgA Nephropathy (IgAN) with other primary glomerular diseases (MCD/FSGS/MN/C3 glomerulopathy). Patients provided informed consent and underwent comprehensive assessments, including medical history, physical examinations, laboratory tests, and imaging. Renal biopsies were performed, and samples were processed using light microscopy, immunofluorescence, and electron microscopy. Data analysis was conducted using IBM SPSS Software.

Results:

Of the 230 patients who underwent native kidney biopsies, 223 were analyzed (Figure 1). The mean age was 36.3±15.9 years, with females comprising 62% of the cohort. Nephrotic syndrome was the most common indication for biopsy (42.2%), followed by nephritic syndrome (16.1%). The most frequent histopathological diagnosis was IgAN (25.1%), followed by lupus nephritis (21.1%). Other diagnoses included FSGS (10.3%), MN (8.1%), and MCD (7.2%). IgAN patients presented later than those with other primary glomerular diseases (median time from symptom onset to presentation: 9.5 months vs. 4.2 months, p=0.001). Hypertension was more prevalent in IgAN (p=0.04). IgAN also demonstrated higher mean serum creatinine (211.4 ± 187.6 µmol/L vs. 112.4 ± 82.9 µmol/L, p=0.001), lower mean hemoglobin (12.2 ± 2.1 g/dL vs. 13.3 ± 2.4 g/dL, p=0.01), and lower mean eGFR (63.8 ± 42.7 ml/min vs. 83.8 ± 38.3 ml/min, p=0.009). Sub-nephrotic proteinuria was predominant in IgAN (67.9% vs. 26.5%), while serum albumin was relatively preserved (34.3 ± 6.9 g/L vs. 29.8 ± 8.2 g/L, p=0.001).

Parameter	IgAN (N=56)	Other Primary GN (N=68)	P-value
Median Time to Presentation (months)	9.5	4.2	0.001
Mean Serum Creatinine (µmol/L)	211.4 ± 187.6	112.4 ± 82.9	0.001
Mean Hemoglobin (g/dL)	12.2 ± 2.1	13.3 ± 2.4	0.01
Mean eGFR (ml/min)	63.8 ± 42.7	83.8 ± 38.3	0.009
Subnephrotic Proteinuria (%)	67.9	26.5	-
Mean Serum Albumin (g/L)	34.3 ± 6.9	29.8 ± 8.2	0.001

Primary GN and Other histological findings

Conclusions:

This study underscores the distinct clinical presentation and laboratory profile of IgA Nephropathy (IgAN) compared to other primary glomerulonephritis in the Nepalese population. Recognizing these unique characteristics is crucial for timely diagnosis and appropriate management of IgAN.

I have no potential conflict of interest to disclose.

I used generative AI and AI-assisted technologies in the writing process.
During the preparation of this work the authors used AI-assisted technologies in order to refine and improve the clarity and language of this abstract. After using these technologies, the authors reviewed and edited the content as needed and take full responsibility for the content of the publication.