*Purpose: Although immunoglobulin A nephropathy (IgAN) is associated with a high risk of renal allograft failure, evidences for its treatment, including renin-angiotensin-aldosterone system blockade (RAASB) usage, remain limited.

*Methods: In this bi-center retrospective cohort study, we included patients who were recently diagnosed with IgAN in allograft biopsies. We identified their 6-month antihypertensive medication prescriptions and investigated the association between the medication types, albuminuria changes, and consequent 5-year death-censored-graft-failure (DCGF). The mixed effect model and cox regression analysis were used.

*Results: A total of 464 allograft IgAN patients were included; consisting of 272, 38, 33, and 121 patients in the no medication, single agent RAASB, single agent beta blocker (BB)/calcium channel blocker (CCB), and combination therapy groups, respectively. High-degree albuminuria after 6 months was an important prognostic parameter and a partial mediator for the association between the subgroups and 5-year DCGF. The usage of single RAASB was associated with decrement of albuminuria from allograft diagnosis (P for interaction = 0.03). The single BB/CCB group demonstrated significantly worse prognosis than the single RAASB group (adjusted hazard ratio, 2.76 [1.09-6.98]; P=0.03).

*Conclusions: In conclusion, RAASB may be beneficial for graft prognosis in early allograft IgAN patients who require single antihypertensive medication therapy, by means of reducing albuminuria.

« Back to 2019 American Transplant Congress