{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T14:26:23Z","timestamp":1782311183377,"version":"3.54.5"},"reference-count":16,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2022,9,1]],"date-time":"2022-09-01T00:00:00Z","timestamp":1661990400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100006484","name":"Vifor Pharma","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006484","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background and objectives<\/jats:title>\n<jats:p>IgA nephropathy (IgAN) is the most common glomerulonephritis worldwide, with an incidence of 2.5 per 100,000 population per year. The 10-year risk of progression to end stage kidney disease (ESKD) or halving of eGFR is 26%. Here we aimed to collect a comprehensive dataset of IgAN patients at our centre over 2 decades to provide real world data, describe outcomes and determine the effects of immunosuppression use.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Design, setting, participants and measurements<\/jats:title>\n<jats:p>All patients diagnosed with biopsy-proven IgAN at our centre over 2 decades were identified. After exclusions, the total cohort size was 401. Data relating to (i) baseline demographics, (ii) laboratory and urine results, (iii) histological data, and (iv) outcomes of initiation of renal replacement therapy (RRT) and mortality were collected.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>The median age was 45.0 years, with 69.6% male and 57.6% hypertensive; 20.4% received immunosuppression, 29.7% progressed to RRT and 19.7% died, over a median follow up period of 51 months. Baseline eGFR was 46.7ml\/min\/1.73m<jats:sup>2<\/jats:sup> and baseline uPCR was 183mg\/mmol. Median rate of eGFR decline was -1.31ml\/min\/1.73m<jats:sup>2<\/jats:sup>\/year. Those with a higher MEST-C score had worse outcomes. Immunosuppression use was associated with an increased rate of improvement in proteinuria, but not with a reduction in RRT or mortality. Factors favouring improved outcomes with immunosuppression use included female gender; lower age, blood pressure and T-score; higher eGFR; and ACEi\/ARB use.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>A variety of clinical and histological factors are important in determining risk of progression in IgAN. Therapeutic interventions, particularly use of immunosuppression, should be individualised and guided by these factors.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0268421","type":"journal-article","created":{"date-parts":[[2022,9,1]],"date-time":"2022-09-01T17:34:21Z","timestamp":1662053661000},"page":"e0268421","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":25,"title":["The epidemiology and evolution of IgA nephropathy over two decades: A single centre experience"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8377-9336","authenticated-orcid":true,"given":"Joshua","family":"Storrar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajkumar","family":"Chinnadurai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4117-4085","authenticated-orcid":true,"given":"Smeeta","family":"Sinha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip A.","family":"Kalra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,9,1]]},"reference":[{"issue":"4","key":"pone.0268421.ref001","doi-asserted-by":"crossref","first-page":"677","DOI":"10.2215\/CJN.07420716","article-title":"IgA Nephropathy.","volume":"12","author":"JC Rodrigues","year":"2017","journal-title":"Clin J Am Soc Nephrol"},{"issue":"9","key":"pone.0268421.ref002","first-page":"694","article-title":"[Intercapillary deposits of IgA-IgG].","volume":"74","author":"J Berger","year":"1968","journal-title":"J Urol Nephrol (Paris)."},{"issue":"5","key":"pone.0268421.ref003","doi-asserted-by":"crossref","first-page":"974","DOI":"10.1038\/ki.2015.252","article-title":"New developments in the genetics, pathogenesis, and therapy of IgA nephropathy","volume":"88","author":"R Magistroni","year":"2015","journal-title":"Kidney Int"},{"issue":"4","key":"pone.0268421.ref004","doi-asserted-by":"crossref","first-page":"828","DOI":"10.1038\/ki.2014.63","article-title":"Validation of the Oxford classification of IgA nephropathy in cohorts with different presentations and treatments","volume":"86","author":"R Coppo","year":"2014","journal-title":"Kidney Int"},{"issue":"24","key":"pone.0268421.ref005","doi-asserted-by":"crossref","DOI":"10.3390\/ijms20246199","article-title":"The Role of IgA in the Pathogenesis of IgA Nephropathy.","volume":"20","author":"M Per\u0161e","year":"2019","journal-title":"Int J Mol Sci."},{"issue":"5","key":"pone.0268421.ref006","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1038\/ki.2009.243","article-title":"The Oxford classification of IgA nephropathy: rationale, clinicopathological correlations, and classification","volume":"76","author":"DC Cattran","year":"2009","journal-title":"Kidney Int"},{"issue":"5","key":"pone.0268421.ref007","doi-asserted-by":"crossref","first-page":"1014","DOI":"10.1016\/j.kint.2017.02.003","article-title":"Oxford Classification of IgA nephropathy 2016: an update from the IgA Nephropathy Classification Working Group","volume":"91","author":"H Trimarchi","year":"2017","journal-title":"Kidney Int"},{"issue":"7","key":"pone.0268421.ref008","doi-asserted-by":"crossref","first-page":"942","DOI":"10.1001\/jamainternmed.2019.0600","article-title":"Evaluating a New International Risk-Prediction Tool in IgA Nephropathy.","volume":"179","author":"SJ Barbour","year":"2019","journal-title":"JAMA Intern Med"},{"issue":"5","key":"pone.0268421.ref009","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1001\/jama.2017.9362","article-title":"Effect of Oral Methylprednisolone on Clinical Outcomes in Patients With IgA Nephropathy: The TESTING Randomized Clinical Trial","volume":"318","author":"J Lv","year":"2017","journal-title":"Jama"},{"issue":"23","key":"pone.0268421.ref010","doi-asserted-by":"crossref","first-page":"2225","DOI":"10.1056\/NEJMoa1415463","article-title":"Intensive Supportive Care plus Immunosuppression in IgA Nephropathy.","volume":"373","author":"T Rauen","year":"2015","journal-title":"New England Journal of Medicine"},{"issue":"5","key":"pone.0268421.ref011","doi-asserted-by":"crossref","first-page":"866","DOI":"10.1681\/ASN.2018101017","article-title":"Mortality in IgA Nephropathy: A Nationwide Population-Based Cohort Study","volume":"30","author":"S Jarrick","year":"2019","journal-title":"J Am Soc Nephrol"},{"issue":"5","key":"pone.0268421.ref012","doi-asserted-by":"crossref","first-page":"883","DOI":"10.1053\/j.ajkd.2013.04.019","article-title":"Mortality in patients with IgA nephropathy","volume":"62","author":"T Knoop","year":"2013","journal-title":"Am J Kidney Dis"},{"issue":"5","key":"pone.0268421.ref013","doi-asserted-by":"crossref","first-page":"925","DOI":"10.1097\/HJH.0000000000002354","article-title":"Long-term blood pressure behavior and progression to end-stage renal disease in patients with immunoglobulin A nephropathy: a single-center observational study in Italy","volume":"38","author":"E Russo","year":"2020","journal-title":"J Hypertens"},{"issue":"12","key":"pone.0268421.ref014","doi-asserted-by":"crossref","first-page":"2343","DOI":"10.1016\/j.numecd.2020.07.038","article-title":"Increased serum uric acid levels are associated to renal arteriolopathy and predict poor outcome in IgA nephropathy.","volume":"30","author":"E Russo","year":"2020","journal-title":"Nutr Metab Cardiovasc Dis"},{"issue":"6","key":"pone.0268421.ref015","doi-asserted-by":"crossref","first-page":"e12936","DOI":"10.1111\/eci.12936","article-title":"First-year GFR slope and long-term renal outcome in IgA nephropathy","volume":"48","author":"K Lee","year":"2018","journal-title":"Eur J Clin Invest"},{"issue":"1","key":"pone.0268421.ref016","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1007\/s10157-018-1582-2","article-title":"Biomarkers for IgA nephropathy on the basis of multi-hit pathogenesis","volume":"23","author":"H. Suzuki","year":"2019","journal-title":"Clinical and experimental nephrology"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0268421","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,9,1]],"date-time":"2022-09-01T17:34:44Z","timestamp":1662053684000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0268421"}},"subtitle":[],"editor":[{"given":"Yasin","family":"Sahin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2022,9,1]]},"references-count":16,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2022,9,1]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0268421","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,1]]}}}