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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.
Proteinuria is the strongest modifiable predictor of disease progression in IgA nephropathy (IgAN). Current guidelines recommend targeting a urine protein-to-creatinine ratio (uPCR) of below 0.5 g/g; however, aiming for deeper remission thresholds may provide better kidney protection. Nevertheless, real-world data supporting the clinical significance of the <0.3 g/g target remains limited. This study aimed to evaluate the clinical, laboratory, and histological predictors of achieving deep proteinuria remission (uPCR <0.3 g/g) and its prognostic value for kidney outcomes.
We conducted a retrospective cohort study that included patients with biopsy-proven IgAN who had at least 24 months of follow-up. We analyzed clinical, laboratory, histological, and therapeutic variables. Deep remission was defined as a uPCR < 0.3 g/g at the 24-month mark. The primary outcome was a composite kidney endpoint: estimated glomerular filtration rate (eGFR) < 30 mL/min, a ≥50% decline in eGFR from baseline, or the initiation of dialysis. Univariate and multivariate logistic regression analyses with Ridge penalization were performed to control for collinearity, and discrimination was assessed using 5-fold cross-validated area under the curve (AUC) measurements. We compared kidney outcome predictions between the uPCR thresholds of < 0.3 g/g and < 0.5 g/g.
A total of 40 patients were included in the study. At the two-year mark, 45% of the patients achieved a uPCR <0.3 g/g. Independent predictors of deep remission included a higher baseline eGFR (odds ratio [OR] 1.04, 95% confidence interval [CI] 1.01–1.09, p=0.01), lower baseline uPCR (OR 0.62, 95% CI 0.41–0.87, p=0.004), the use of immunosuppressive therapy (OR 2.35, 95% CI 1.28–5.42, p=0.02), absence of hematuria at 2 years (OR 0.41, 95% CI 0.19–0.86, p=0.01), and lower severity of T1–2 lesions (OR 0.55, 95% CI 0.29–0.92, p=0.03). For the composite kidney outcome, a uPCR <0.3 was significantly associated with kidney survival (OR 0.34, 95% CI 0.13–0.79, p=0.009; AUC 0.88±0.04), while a PCR <0.5 did not reach significance (OR 0.57, 95% CI 0.25–1.25, p=0.14; AUC 0.85±0.05). (Figure 1)
Achieving deep proteinuria remission independently predicts superior kidney survival in IgAN and outperforms the traditional <0.5 g/g threshold. Therefore, aiming for a uPCR <0.3 should be considered a therapeutic goal and a potential surrogate endpoint in future clinical trials.
