OBJECTIVES: Immunoglobulin A nephropathy (IgAN), the glomerular accumulation of IgA-containing immune complexes in the kidneys, may lead to damage of the glomerular filtration barrier which results in proteinuria, hematuria, and often kidney failure (KF). This study describes the epidemiology, treatments, clinical outcomes, and resource burden of patients with IgAN using United States Veteran’s Affairs (VA) data.

METHODS: This study used data from the National VA Health Care Network from October 1999 to February 2021. Patients with ≥2 diagnoses of IgAN were included (first IgAN diagnosis as index date), and were required to have continuous enrollment for ≥6 months before and ≥12 months after index. Annual incidence and prevalence of IgAN were evaluated. Patient characteristics at index and treatments, healthcare resource utilization, and healthcare costs during the year following index were described. Overall survival and time to KF from index were assessed using Kaplan-Meier analysis.

RESULTS: From 2000-2020, average IgAN incidence and period prevalence rates were 67.0 and 589.0 per million VA-enrolled veterans, respectively. Of 8,243 patients in the final cohort, median age at index was 63 years and 96% male. The most commonly used treatments during 12-month follow-up included statins (60%), ACE inhibitors (56%), and calcium channel blockers (47%). 31% of patients had an inpatient admission, with an average 26 days in the hospital and average 26 outpatient visits during 12-month follow-up. Average total healthcare costs were $30,754 during the 12-month follow-up, driven by inpatient ($12,823) and outpatient ($12,536) costs. Five- and ten-year survival rates were 76% and 51%, respectively. Median time to KF was 6.2 years, and 5-year rate of KF was 44%.

CONCLUSIONS: Among the VA population, IgAN is associated with substantial clinical and resource burden. Safe and effective therapies approved for IgAN would significantly improve the lives of patients and reduce patient and healthcare system burden.