{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T11:36:29Z","timestamp":1786534589425,"version":"build-2736575974"},"reference-count":0,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>While proteinuria is a well-established surrogate marker in IgA nephropathy (IgAN), the independent prognostic value of early hematuria remission remains unclear. We hypothesized that treatment response at 6 months, particularly hematuria status, is associated with subsequent kidney outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a single-center retrospective cohort study of biopsy-proven IgAN at Hiroshima University Hospital between April 2010 and March 2024. A 6-month landmark analysis was used to minimize immortal time bias, including patients who were event-free at 6 months, with follow-up starting at that time. Urinary red blood cell (uRBC) count at 6 months was used to classify patients into remission (&amp;lt;5 RBC\/high-power field [HPF]), persistent moderate (5\u201329 RBC\/HPF), and persistent severe (\u226530 RBC\/HPF). The primary outcome was a composite of end-stage kidney disease or a \u226530% decline in the estimated glomerular filtration rate. Multivariable Cox models, Kaplan\u2013Meier analyses, and restricted cubic spline models were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 286 patients were analyzed (median age 43 years; 48.2% male). During a median follow-up of 3.1 years, 38 patients (13.3%) reached the composite outcome. Compared with remission, persistent severe hematuria was associated with higher risk of the outcome (hazard ratio 2.97, 95% confidence interval 1.33\u20136.67, P = 0.01). Restricted cubic spline analyses demonstrated a graded association between higher uRBC count and worse kidney outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Persistent severe hematuria at 6 months was independently associated with worse kidney outcomes. Monitoring hematuria at 6 months may provide a clinically useful marker for risk stratification in patients with IgAN.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/joneph\/aajag223","type":"journal-article","created":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T11:40:56Z","timestamp":1786448456000},"source":"Crossref","is-referenced-by-count":0,"title":["Association between hematuria remission at 6 months and subsequent kidney outcomes in IgA nephropathy"],"prefix":"10.1093","author":[{"given":"Keiko","family":"Onoue","sequence":"first","affiliation":[{"name":"Department of Nephrology, Hiroshima University Hospital , Hiroshima ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5566-3157","authenticated-orcid":false,"given":"Aiko","family":"Okubo","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hiroshima University Hospital , Hiroshima ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hiroshima University Hospital , Hiroshima ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akira","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hiroshima University Hospital , Hiroshima ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yosuke","family":"Osaki","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hiroshima University Hospital , Hiroshima ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoki","family":"Ishiuchi","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hiroshima University Hospital , Hiroshima ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1808-2772","authenticated-orcid":false,"given":"Yujiro","family":"Maeoka","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hiroshima University Hospital , Hiroshima ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kensuke","family":"Sasaki","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hiroshima University Hospital , Hiroshima ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takao","family":"Masaki","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hiroshima University Hospital , Hiroshima ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,8,12]]},"container-title":["Journal of Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/joneph\/advance-article-pdf\/doi\/10.1093\/joneph\/aajag223\/70616890\/aajag223.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/joneph\/advance-article-pdf\/doi\/10.1093\/joneph\/aajag223\/70616890\/aajag223.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T11:02:49Z","timestamp":1786532569000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/joneph\/advance-article\/doi\/10.1093\/joneph\/aajag223\/8759455"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,12]]},"references-count":0,"URL":"https:\/\/doi.org\/10.1093\/joneph\/aajag223","relation":{},"ISSN":["1121-8428","1724-6059"],"issn-type":[{"value":"1121-8428","type":"print"},{"value":"1724-6059","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,12]]},"article-number":"aajag223"}}