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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.
IgA nephropathy (IgAN) is the most common primary glomerular disease worldwide and carries a substantial risk of progression to end-stage renal disease (ESRD). In Japan, tonsillectomy combined with steroid pulse therapy (TSP) has been widely adopted as a treatment strategy to induce remission of proteinuria and hematuria. Although TSP has been reported to achieve high rates of urinary remission, a proportion of patients continue to exhibit persistent urinary abnormalities after treatment. The renal prognosis associated with these residual abnormalities remains poorly defined, and the clinicopathological characteristics of such cases have not been fully elucidated. Therefore, this study aimed to evaluate renal outcomes according to post-TSP urinary abnormality patterns and to investigate the clinical and pathological features at the time of kidney biopsy in these patient subgroups.
A retrospective study was conducted on 187 patients diagnosed with IgAN and treated with TSP at Juntendo University Hospital between 2012 and 2021. IgAN patients were classified into four groups based on urinary findings six months post-TSP: complete remission, persistent proteinuria, persistent hematuria, and persistent proteinuria and hematuria. Renal outcomes and clinicopathological data at the time of kidney biopsy of each group were analyzed. Cumulative probabilities of 30% increase in s-Cr or 30% decline in eGFR from baseline were analyzed using the Kaplan–Meier method, and differences in curves were compared using the log-rank test.
Among the 187 patients, 73.3% achieved complete remission of both proteinuria and hematuria following TSP. Persistent proteinuria, hematuria, and combined proteinuria with hematuria were observed in 13.9%, 8.6%, and 4.3% of patients, respectively. Patients with any persistent urinary abnormality exhibited a significantly higher risk of renal function decline compared with those achieving complete remission, with the poorest prognosis observed in the persistent proteinuria group. At baseline, patients with persistent proteinuria had higher blood pressure, body mass index (BMI), and a greater prevalence of dyslipidemia and hyperuricemia. Persistent hematuria was associated with thinner glomerular basement membranes on biopsy evaluation.
Persistent urinary abnormalities after TSP are associated with an increased risk of renal function deterioration in patients with IgAN. Persistent proteinuria may reflect non-immunological mechanisms; thus, early initiation of adjunctive non-immunological therapies, such as optimized blood pressure and lipid management, may improve long-term outcomes. Although persistent hematuria might be related to structural abnormalities of the glomerular basement membrane, the poor renal prognosis observed in this group suggests ongoing glomerular injury. Careful monitoring is warranted even in patients with isolated hematuria. Further prospective studies are needed to clarify the pathophysiological mechanisms underlying persistent urinary findings and to refine post-TSP management strategies.
