IgA Nephropathy in the Elderly
Introduction: Knowledge about IgA nephropathy (IgAN) presentation and prognosis for elderly patients is limited. We assessed clinical and histologic findings among patients aged ≥ 60 years at diagnosis and examined factors associated with the risk of kidney failure and death. Methods: We identified...
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Elsevier
2025-08-01
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| Series: | Kidney International Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2468024925003146 |
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| author | Dana V. Rizk Emily Dryer Ashutosh Tamhane Jan Novak Bruce A. Julian Robert J. Wyatt |
| author_facet | Dana V. Rizk Emily Dryer Ashutosh Tamhane Jan Novak Bruce A. Julian Robert J. Wyatt |
| author_sort | Dana V. Rizk |
| collection | DOAJ |
| description | Introduction: Knowledge about IgA nephropathy (IgAN) presentation and prognosis for elderly patients is limited. We assessed clinical and histologic findings among patients aged ≥ 60 years at diagnosis and examined factors associated with the risk of kidney failure and death. Methods: We identified those patients at our center between 1996 and 2020. Age, sex, race, chronic kidney disease (CKD) stage, and histologic MEST-C classification at biopsy were collected. Outcomes of kidney failure and death were ascertained by using United States Renal Data System (USRDS) and National Death Index (NDI), respectively. Associations of baseline predictors with kidney failure were examined by using cause-specific Cox hazards regression with all-cause mortality as competing risk. For all-cause mortality, standard Cox proportional hazards regression analysis was used. Cumulative survival probabilities were examined using Kaplan-Meier survival curves. Results: Among 127 patients, median estimated glomerular filtration rate (eGFR) was 25 ml/min per 1.73 m2, 81% had proteinuria ≥ 1000 mg/g creatinine, 35% and 17% had CKD stages 4 and 5, respectively. Forty-five patients progressed to kidney failure and 86 died. Overall, Kaplan-Meier estimate of median time to kidney failure was 11.3 years and to death was 7.5 years. Males were more likely to progress to kidney failure than females. Kidney failure strongly associated with CKD stages 3, 4, and 5 versus stages 1 or 2; findings remained unchanged after adjusting for histology. Mortality was associated with increasing age and advanced CKD. Conclusion: IgAN diagnosed at elderly age is associated with severe clinical phenotype and portends a poor prognosis because of high risk of kidney failure and death. |
| format | Article |
| id | doaj-art-8fbffb4d7fc64bd9aabe256f365418e3 |
| institution | Kabale University |
| issn | 2468-0249 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Kidney International Reports |
| spelling | doaj-art-8fbffb4d7fc64bd9aabe256f365418e32025-08-20T03:58:11ZengElsevierKidney International Reports2468-02492025-08-011082651265810.1016/j.ekir.2025.05.012IgA Nephropathy in the ElderlyDana V. Rizk0Emily Dryer1Ashutosh Tamhane2Jan Novak3Bruce A. Julian4Robert J. Wyatt5Division of Nephrology, Department of Medicine, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA; Correspondence: Dana V. Rizk, Division of Nephrology, Department of Medicine, Heersink School of Medicine, University of Alabama at Birmingham, ZRB 614, 1720 2nd Avenue South Birmingham, Alabama 35294, USA.Division of Nephrology, Department of Medicine, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA; Munson Healthcare Kidney and Hypertension Specialists, Traverse City, Michigan, USADivision of Nephrology, Department of Medicine, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USADepartment of Microbiology, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USADivision of Nephrology, Department of Medicine, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USADepartment of Pediatrics, University of Tennessee Health Sciences Center, Memphis, Tennessee, USA; Children’s Foundation Research Institute, Memphis, Tennessee, USAIntroduction: Knowledge about IgA nephropathy (IgAN) presentation and prognosis for elderly patients is limited. We assessed clinical and histologic findings among patients aged ≥ 60 years at diagnosis and examined factors associated with the risk of kidney failure and death. Methods: We identified those patients at our center between 1996 and 2020. Age, sex, race, chronic kidney disease (CKD) stage, and histologic MEST-C classification at biopsy were collected. Outcomes of kidney failure and death were ascertained by using United States Renal Data System (USRDS) and National Death Index (NDI), respectively. Associations of baseline predictors with kidney failure were examined by using cause-specific Cox hazards regression with all-cause mortality as competing risk. For all-cause mortality, standard Cox proportional hazards regression analysis was used. Cumulative survival probabilities were examined using Kaplan-Meier survival curves. Results: Among 127 patients, median estimated glomerular filtration rate (eGFR) was 25 ml/min per 1.73 m2, 81% had proteinuria ≥ 1000 mg/g creatinine, 35% and 17% had CKD stages 4 and 5, respectively. Forty-five patients progressed to kidney failure and 86 died. Overall, Kaplan-Meier estimate of median time to kidney failure was 11.3 years and to death was 7.5 years. Males were more likely to progress to kidney failure than females. Kidney failure strongly associated with CKD stages 3, 4, and 5 versus stages 1 or 2; findings remained unchanged after adjusting for histology. Mortality was associated with increasing age and advanced CKD. Conclusion: IgAN diagnosed at elderly age is associated with severe clinical phenotype and portends a poor prognosis because of high risk of kidney failure and death.http://www.sciencedirect.com/science/article/pii/S2468024925003146elderlyIgA nephropathyIgANkidney failuremortality |
| spellingShingle | Dana V. Rizk Emily Dryer Ashutosh Tamhane Jan Novak Bruce A. Julian Robert J. Wyatt IgA Nephropathy in the Elderly Kidney International Reports elderly IgA nephropathy IgAN kidney failure mortality |
| title | IgA Nephropathy in the Elderly |
| title_full | IgA Nephropathy in the Elderly |
| title_fullStr | IgA Nephropathy in the Elderly |
| title_full_unstemmed | IgA Nephropathy in the Elderly |
| title_short | IgA Nephropathy in the Elderly |
| title_sort | iga nephropathy in the elderly |
| topic | elderly IgA nephropathy IgAN kidney failure mortality |
| url | http://www.sciencedirect.com/science/article/pii/S2468024925003146 |
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