In IgA Nephropathy and FSGS

Proteinuria Could Be Putting Your Patients at High Risk

Proteinuria is a key prognostic indicator of progression in both IgA nephropathy and FSGS1-8

Proteinuria perpetuates a cycle of kidney fibrosis, as proximal tubular reabsorption of excess protein contributes to tubulointerstitial injury5,7,8

Reduction in proteinuria results in a decrease in glomerular pressure and reduction of podocyte damage.1

Lower proteinuria levels are critical to preserving kidney function1,9,10

TARGETED PROTEINURIA GOALS1,3

IgA nephropathy
Downward pointing arrows to signify the importance of lowering proteinuria to targeted levels
<1.0 g/d
FSGS
Downward pointing arrows to signify the importance of lowering proteinuria to targeted levels
<1.5 g/ga
Achieving these targeted proteinuria goals correlates with extended kidney survival

aFSGS partial remission threshold defined as <1.5 g/g with a 40% reduction from baseline.

Evidence-based thresholds translate to clinically meaningful treatment goals

Despite receiving standard-of-care treatment, many patients face a poor prognosis due to elevated proteinuria levels, making the need for novel medications urgent.1

Explore the role of ET-1 and Ang II

Ang II=angiotensin II; ET-1=endothelin-1; FSGS=focal segmental glomerulosclerosis; IgA=immunoglobulin A.

References:

1. Kidney Disease: Improving Global Outcomes (KDIGO) Glomerular Diseases Work Group. Kidney Int. 2021;100(4S):S1-S276. 2. Troyanov S, et al. J Am Soc Nephrol. 2005;16:1061-1068. 3. Inker LA, et al. Am J Kidney Dis. 2016:1-10. 4. D’Agati VD, et al. New Engl J Med. 2011;365:2398-2411. 5. Remuzzi G, et al. New Engl J Med. 1998;339:1448-1456. 6. Ruggenenti P, et al. Kidney Int. 1998;53:1209-1216. 7. Dhaun N, et al. Br J Pharmacol. 2012;167:720-731. 8. Cravedi P, et al. Br J Clin Pharmacol. 2013;76(4):516-523. 9. Troost JP, et al. Am J Kidney Dis. 2021;77:216-225. 10. Troost JP, et al. Clin J Am Soc Nephrol. 2018;13:414-421. 11. Komers R, et al. Am J Physiol Regul Integr Comp Physiol. 2016:R877-R884. 12. Kohan DE, et al. Kidney Int. 2014;86:896-904. 13. Raina R, et al. Kidney Dis. 2020;6:22-34.

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