Vascular Lesions Linked to Poor Renal Outcomes in IgA Nephropathy: Study

A study published in the journal of BMC Nephrology found that patients with IgA nephropathy (IgAN) who have vascular lesions, including arteriosclerotic changes or microangiopathy (MA), face a significantly higher risk of adverse kidney outcomes. Even after adjusting for confounding factors, the presence of vascular lesions remained associated with worse renal prognosis in IgAN patients.

IgAN is a leading cause of end-stage renal disease (ESRD), where the kidneys can no longer function adequately. Traditionally, IgAN prognosis has focused heavily on glomerular pathology and immune-related mechanisms. However, the study highlights the importance of evaluating vascular lesions during kidney biopsy assessments, as they may provide additional prognostic information beyond current classification systems. While studies have long looked into the impact of inflammation and immune deposits in IgAN, the latest findings place renewed focus on vascular injury as a key predictor of long-term renal decline.

The study analyzed data from 16 independent studies across six countries, included a total of 8,862 patients diagnosed with IgAN. This comprehensive review of medical literature from Embase, PubMed, Cochrane Library, and Web of Science databases through November 8, 2025. The investigation determined whether vascular lesions could independently predict poor kidney outcomes in affected individuals.

According to the pooled analysis, these patients with arteriosclerotic lesions faced nearly double the risk of adverse renal outcomes when compared to those without such lesions. The hazard ratio (HR) was calculated at 1.95, which indicated a statistically significant increase in the risk of kidney deterioration. The patients exhibiting microangiopathy underwent a substantially elevated risk of disease progression, with a hazard ratio of 1.98. When vascular lesions were considered collectively reaching a hazard ratio of 2.27.

These associations remained statistically significant even after adjusting for confounding factors like blood pressure, baseline kidney function, and proteinuria. This suggests that vascular damage itself may independently contribute to worsening kidney health in IgAN patients.

Overall, these findings highlight the urgent need for earlier detection and more targeted therapies to protect kidney blood vessels. As IgAN continues to be a major contributor to chronic kidney disease and ESRD worldwide, which identifies the high-risk patients earlier and could improve treatment strategies and long-term outcomes.

Reference:

Lei, Z., Xu, Y., Guo, L., Liu, Y., Zeng, J., & Lv, J. (2026). Prognostic value of vascular lesions in immunoglobulin a nephropathy: a meta-analysis. BMC Nephrology. https://doi.org/10.1186/s12882-026-05053-2