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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
Several prognostic models for IgA nephropathy (IgAN) have been proposed, including the Oxford classification and the Japanese clinical–histological grading system. However, most previous studies included patients who received intensive treatments, such as immunosuppressive therapy, making it difficult to distinguish the natural course of the disease from treatment effects. This study aimed to identify prognostic factors in patients with IgA nephropathy who received conservative therapy without immunosuppressive therapy, including steroids, or tonsillectomy.
This retrospective study used the JNR-IgAN database of the Progressive Renal Disease Research Group. Of the 1,174 patients aged 18 years or older who were diagnosed with IgA nephropathy by kidney biopsy between 2002 and 2004, 185 patients who received conservative treatment were included in the analysis. The primary outcome was defined as the first occurrence of either a 1.5-fold increase in serum creatinine from baseline or the initiation of dialysis. Prognostic factors were analyzed by log-rank tests and Cox models.
Clinical grade (CG) was classified by urinary protein (UP) and eGFR: CG1: UP <0.5 g/day and eGFR ≥60 mL/min/1.73 m², CG2: UP ≥0.5 g/day and eGFR ≥60 mL/min/1.73 m², CG3: UP <0.5 g/day and eGFR <60 mL/min/1.73 m², CG4: UP ≥0.5 g/day and eGFR <60 mL/min/1.73 m².
The histological grade (HG) was determined according to the percentage of glomeruli with global sclerosis, segmental sclerosis, or crescents: HG1: <25%, HG2: 25–49%, HG3: 50–74%, HG4: ≥75%
Lesions were further classified as active (cellular/fibrocellular crescents) or chronic (fibrous crescents, segmental/global sclerosis). In addition, a subgroup analysis was performed in 83 patients whose biopsy specimens could be evaluated according to the Oxford MEST classification.
In the log-rank tests performed for all cases, C grade, H grade, and each Oxford MEST were all significantly associated with renal outcome. When stratified by baseline eGFR (≥60 vs. <60 mL/min/1.73 m²), no significant difference was observed in the ≥60 group, whereas a significant difference was found in the <60 group. A comparison between patients with and without active lesions showed no significant difference in renal outcomes in the overall cohort. However, among patients with H grade I, those with active lesions had significantly worse renal outcomes than those without. In the multivariate Cox proportional hazards model, urinary protein excretion, eGFR, hematuria (>3+), and endocapillary hypercellularity (E lesion) were identified as independent predictors of a 1.5-fold increase in serum creatinine.
In patients with IgA nephropathy who did not receive immunosuppressive therapy or tonsillectomy, not only proteinuria and eGFR but also severe hematuria and the presence of E lesions were found to affect renal prognosis. The presence of active lesions was associated with renal outcomes only in patients with H grade I, while MEST lesions were associated with renal prognosis in patients whose eGFR was below 60 mL/min/1.73 m² at the time of biopsy.
In patients with IgA nephropathy receiving conservative therapy, a comprehensive evaluation of clinical and pathological parameters at the time of biopsy is considered essential for improving renal outcomes.
