ORIGINAL RESEARCH article
Front. Nephrol.
Sec. Glomerular disease
This article is part of the Research TopicEmerging Strategies and Insights in IgA Nephropathy ResearchView all articles
Treatment practices, characteristics and outcome of Immunoglobulin A Nephropathy – a Swiss single center experience
Provisionally accepted
- 1Inselspital Universitatsspital Bern Universitatsklinik fur Nephrologie und Hypertonie, Bern, Switzerland
- 2Kantonsspital Aarau AG, Aarau, Switzerland
- 3Universitat Bern, Bern, Switzerland
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Introduction: Immunoglobulin A nephropathy (IgAN) is the most common primary glomerulonephritis worldwide. Geographic differences in disease course and treatment response are well recognized. The purpose of this analysis was to study clinical and histological characteristics, treatment practices and outcome of IgAN cases from a Swiss tertiary center. Methods: This retrospective cohort analysis identified 158 cases of adult biopsy-proven IgAN by chart review diagnosed between 1980 and 2016. Following detailed phenotyping, standard descriptive methods and univariate analysis were applied. Results: The majority of patients was male and of European ancestry. At diagnosis, mean estimated glomerular filtration rate (eGFR) was 55.7 ml/min/1.73 m2, mean proteinuria was 2.4 g/d and 69.9% of the patients were hypertensive. Clinical presentation varied according to age. Initial biopsies showed moderate to severe tubular atrophy and interstitial fibrosis (IFTA) in 29.1% and crescents in 36.7% of cases. Therapy included renin-angiotensin-aldosterone-inhibitors in 86.7% as well as immunosuppressive therapy in 46.8% including steroids and other immunosuppressive drugs (28.7%), mainly azathioprin. Outcome included 34.1% complete and 22.2% partial remissions, relapses in 32.0% of patients, while 43.0% of patients progressed to ESKD during follow-up (median 100.0 months). Recurrence rate after transplantation was 18.8%. Immunosuppressive therapy was more frequently used in patients with higher proteinuria level, higher hematuria grade, lower eGFR, more intense IgA and complement C3 staining and crescents. Predictors of progression were higher age, lower eGFR, higher proteinuria and blood pressure as well as crescents and higher extent of IFTA on the initial biopsy. Conclusions: This retrospective cohort analysis gives insight into characteristics and outcome of patients with IgAN from a Swiss tertiary center, treatment practices as well as predictors of outcome and therapy choices. A comparatively high use of immunosuppressive treatment including non-steroid-based regimens was found along with a high rate of progression to ESKD.
Keywords: Cohort analysis, end-stage kidney disease, Glomerular Filtration Rate, Glomerulonephritis, Hematuria, IgA nephropathy, Immunosuppression, Proteinuria
Received: 06 Oct 2025; Accepted: 05 Jan 2026.
Copyright: © 2026 Taing, Vogt and Mani. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Laila-Yasmin Mani
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