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. 2021 Mar 10;2(5):828–841. doi: 10.34067/KID.0006972020

Figure 5.

Figure 5.

Factors involved in IgAN progression to ESKD. Individual nephron endowment may determine the sensitivity to progressive nephron loss when it encounters acquired kidney diseases such as chronic glomerulopathies including IgAN. In 245 patients with IgAN analyzed in this study, single-nephron GFR level was largely unchanged among the different CKD stage groups, but varied significantly between individuals in the same CKD stages. Increased UPE levels were more pronounced at the single-nephron level in advanced CKD stages. This study therefore indicates “biphasic” vulnerability of single-nephron GFR (hyper- or hypoglomerular filtration) is involved in the progression of IgAN to ESKD. Some of histopathological findings specific to IgAN may interfere with the ability to achieve compensatory hyperfiltration during progressive nephron loss. CKD, chronic kidney disease; ESKD, end-stage kidney disease; GFR, glomerular filtration rate; IgAN, immunoglobulin A nephropathy; Kf, glomerular capillary ultrafiltration coefficient; ΔP, transcapillary hydraulic pressure difference; UPE, urinary protein excretion.