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Validation of IgA nephropathy diagnosis in the Swedish Renal Registry
Örebro University, School of Medical Sciences. Department of Nephrology and Centre for Clinical Research, County Council of Värmland, Central Hospital Karlstad, Karlstad, Sweden.
Department of Endocrinology, Nephrology and Rheumatology, Skåne University Hospital, Lund, Sweden; Department of Clinical Sciences, Lund University, Lund, Sweden.
Örebro University Hospital. Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden; Department of Pediatrics, Örebro University Hospital, Örebro, Sweden; Division of Digestive and Liver Disease, Department of Medicine, Columbia University Medical Center, New York, NY, USA; Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, UK.ORCID iD: 0000-0003-1024-5602
School of Medical Science, University of Örebro, Örebro, Sweden; Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden; Nysäter Health Care Center, Centre for Clinical Research, County Council of Värmland, Nysäter, Sweden; Department of General Practice and General Practice Research Unit (AFE), Institute of Health and Society, University of Oslo, Oslo, Norway.
2024 (English)In: BMC Nephrology, E-ISSN 1471-2369, Vol. 25, no 1, article id 78Article in journal (Refereed) Published
Abstract [en]

AIM: The Swedish Renal Registry (SRR) is a unique national quality registry that monitors the clinical trajectory of patients with chronic kidney disease (CKD). We have validated the biopsy data registered in the SRR for IgA Nephropathy (IgAN) diagnosis.

METHODS: In total 25% of all patients (n = 142), registered with IgAN in the SRR after having performed a kidney biopsy during 2015-2019, were randomly selected. We obtained original biopsy and medical records for 139 (98%) patients. We evaluated the IgAN diagnosis using a standardized template, calculated its positive predictive value (PPV) with 95% confidence interval (CI) and reported clinical features at the time of diagnosis.

RESULTS: A histological and clinical diagnosis of IgAN was confirmed in 132 of the 139 patients, yielding a PPV of 95% (95% CI 90-98%). Median age was 46 years (range: 18-85) and the male:female ratio was 2.1:1. The median creatinine level was 123 µmol/L, with a corresponding estimated glomerular filtration rate (eGFR) level of 51 mL/min/1.73m2. Histological features of IgA deposits were seen in all patients, hypercellularity in 102/132 (77.2%), C3 deposits in 98/132 (72.4%) and C1q deposits in 27/132 (20.5%) of the cases.

CONCLUSION: Validating data is not research per se, but continuous validation of medical registries is an important feature necessary to ensure reliable data and the foundation of good epidemiological data for future research. Our validation showed a high PPV (95%) for IgAN diagnosis registered in the SRR. Clinical characteristics were consistent with previous reports. The biopsy data in the SRR will be a valuable resource in future IgAN research.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2024. Vol. 25, no 1, article id 78
Keywords [en]
IgA nephropathy, Kidney biopsy, Swedish Renal Registry, Validation
National Category
Clinical Medicine
Identifiers
URN: urn:nbn:se:oru:diva-112098DOI: 10.1186/s12882-024-03512-2ISI: 001178124700001PubMedID: 38438966Scopus ID: 2-s2.0-85186551952OAI: oai:DiVA.org:oru-112098DiVA, id: diva2:1842487
Funder
Örebro UniversityRegion VärmlandAvailable from: 2024-03-05 Created: 2024-03-05 Last updated: 2025-09-17Bibliographically approved
In thesis
1. IgA Nephropathy: Comorbidities and Prognosis - Registry-based Studies
Open this publication in new window or tab >>IgA Nephropathy: Comorbidities and Prognosis - Registry-based Studies
2025 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

This thesis investigates the associations between IgA nephropathy (IgAN), a common form of primary glomerulonephritis, and several health outcomes including inflammatory bowel disease (IBD), cancer, infections, and the reliability of biopsy data from the Swedish Renal Registry (SRR).

In a population-based cohort study of 3,963 IgAN patients and 19,978 controls, IgAN was linked to a significantly higher risk of both future and preceding IBD diagnoses. IBD also increased the risk of developing end-stage renal disease (ESRD) in IgAN patients, underscoring the importance of monitoring gastrointestinal comorbidities in this population.

Another cohort study of 3,882 IgAN patients examined the association between IgAN and cancer. An elevated cancer risk was identified, but only in patients who progressed to ESRD, suggesting that the increased cancer incidence is related to advanced kidney disease rather than IgAN itself.

A third study explored the frequency of infections in IgAN patients, revealing a higher incidence of infections and increased antimicrobial use compared to both the general population and sibling controls. The study highlighted a marked risk of sepsis, emphasizing the need for proactive infection prevention in IgAN management.

Finally, validation of biopsy data from the SRR demonstrated a high positive predictive value (95%) for IgAN diagnosis. This reinforces the reliability of the SRR as a valuable tool for future research on IgAN.

Together, these findings contribute to a deeper understanding of IgAN’s broader clinical implications, and the potential risks associated with its progression.

Place, publisher, year, edition, pages
Örebro: Örebro University, 2025. p. 88
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 330
Keywords
IgA Nephropathy, Epidemiology, Comorbidities
National Category
General Medicine
Identifiers
urn:nbn:se:oru:diva-120648 (URN)9789175296760 (ISBN)9789175296777 (ISBN)
Public defence
2025-10-17, Örebro universitet, Campus USÖ, Tidefeltsalen, Södra Grev Rosengatan 32, Örebro, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2025-04-16 Created: 2025-04-16 Last updated: 2025-09-19Bibliographically approved

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Rehnberg, JohannaLudvigsson, Jonas F.

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