IgAN Lab Results: EGFR, Proteinuria, and Insights for Kidney Health
Urological HealthKidney Diseases

Decoding Your IgAN Lab Results: Understanding EGFR and UPCR, and Predicting Future Kidney Health

Decoding Your IgAN Lab Results: Understanding EGFR and UPCR, and Predicting Future Kidney Health
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Published on January 29, 2026
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For many people with IgA nephropathy (IgAN), a condition in which immunoglobulin A (IgA) antibodies accumulate in the kidneys and trigger inflammation, kidney function stays stable for many years. For others, the inflammation damages the kidneys more rapidly, leading to kidney failure.

 Because the course of IgAN can vary so much, regular follow-ups and lab testing are an important part of managing the condition.
To monitor kidney function, healthcare providers generally look closely at two lab results.

 One is the estimated glomerular filtration rate (eGFR), which is a score that shows how well the kidneys are filtering waste from your blood.

 The other is the urine protein-to-creatinine ratio (uPCR), which measures the amount of protein in the urine (proteinuria).

 If you’re living with IgAN, learning what these lab results mean and how they may change over time can help you feel more prepared and involved in your care. Here’s what nephrologists say you should understand about your IgAN lab results.

What Is EGFR and Why Does It Matter?

EGFR is a blood test that helps healthcare providers assess overall kidney function, says Samir Parikh, MD, a nephrologist and clinical professor of internal medicine at the Ohio State University College of Medicine. It estimates how well your kidneys are filtering waste from your blood.

What the Numbers Mean

EGFR represents how many milliliters (ml) of blood your kidneys can filter in one minute.

 “You can think of it as being roughly the percentage of kidney function, where higher is better,” says Christopher K. Johnson, MD, a board-certified nephrologist and the medical director of OSF HealthCare in Peoria, Illinois. For example, an eGFR of 70 means your kidneys are filtering about 70 ml of blood per minute, or are roughly 70 percent efficient compared with healthy kidneys.
In general, here’s how healthcare providers interpret eGFR ranges:

  • Greater than 60 This is considered a normal, healthy range. Many labs simply report this as “>60” because values above this level are not generally clinically different from one another.
  • 15 to 59 There’s a loss of kidney function, and the lower the number, the more severe the loss.
  • 10 to 15 This range identifies very low kidney function or kidney failure, close to the point where dialysis may be needed, says Dr. Johnson.

Healthcare providers also use eGFR to classify chronic kidney disease from stage 1 to 5, says Dr. Parikh.

Graphic titled The Stages of Chronic Kidney Disease. Illustrated points include stage 1, stage 2, stage 3a, stage 3b, stage 4, and stage 5. eGFR 90 or above, mild, few or none. 60-89, mild, few or none. 45-59, mild to moderate, mild to moderate symptoms
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Why Your EGFR Trend Matters

EGFR is not an exact number, and it can bounce around a little from test to test. This is usually normal, says Johnson. If one test shows an eGFR of 47, the next one comes back at 44, and a later test shows 48, that’s okay because the pattern consists of numbers in the same range, which means the eGFR is stable, he says.

“What’s concerning is if we see an ongoing trend of worsening eGFR over months or years,” says Johnson. If kidney function is going down by 1 percent to 3 percent per year consistently, that suggests disease progression, and treatment is needed to slow things down, he says.

A decline of more than 3 percent per year is more serious and suggests a higher risk of progressing to end-stage renal disease and needing dialysis if the trend continues, says Johnson.

What This Means for People With IgAN

With IgAN, some people can lose more than 5 ml of kidney-filtering ability each year.

 This means that someone with an eGFR of 30 who continues to lose kidney function at 5 ml per year could reach kidney failure within a few years. “But the medications available today are designed to change this trajectory and slow the rate of progression,” Parikh says.
Healthcare providers don’t consider the eGFR trend alone. “We also factor blood pressure and proteinuria level, as these are the most important modifiable risk factors in IgAN,” says Parikh. Modifiable risk factors are those that can be changed with treatment and lifestyle changes. Reducing proteinuria and keeping blood pressure well controlled are two of the most important ways to slow kidney damage in IgAN, says Parikh, and both can be addressed through medication and lifestyle changes.

What Is UPCR, and Why Does It Matter?

Healthcare providers use uPCR to measure proteinuria, a medical term for excess protein in the urine.

 While eGFR measures how well your kidneys are working, proteinuria shows whether protein is leaking through the kidney filters.
For uPCR, the amount of protein in your urine is measured against the level of creatinine.

 Creatinine is a waste product that the kidneys filter out of the blood and into the urine.

 Because urine creatinine levels stay fairly consistent, it’s used as a gauge for a more reliable measurement of proteinuria, even when protein levels fluctuate.

If your uPCR numbers change unexpectedly, a 24-hour urine collection may be necessary for the most accurate measurement of proteinuria, says Parikh.

Understanding Proteinuria

The tiny filters in healthy kidneys allow only small waste products to pass through into the urine while keeping large, helpful molecules, like proteins, in your blood.

 When those filters are damaged, protein can leak into the urine. In IgAN, this damage occurs when IgA antibodies accumulate in the kidneys.

Proteinuria is both a warning sign and part of the problem. Having protein in your urine is a sign that the filters have already been damaged, while leaked protein can also irritate other parts of the kidneys, contributing to further damage, says Parikh. Many of the treatments used for IgAN are designed to reduce proteinuria and help protect the kidneys.

What the Numbers Mean

UPCR results are reported as grams of protein per gram of creatinine, abbreviated as g/g.

 You can think of these numbers in milligrams (mg). For example, a result of 1.0 g/g is roughly equal to 1,000 mg of protein leaking over a full day. The lower the uPCR number, the better. Here’s how to interpret the numbers, according to Johnson:

  • Under 0.2 g/g This is often the goal. It means less than 200 mg of protein is leaking into the urine, which is considered a healthy range.
  • 0.2 to 0.5 g/g You may not need treatment, depending on many factors, such as age, blood pressure, eGFR, and the medications you are taking.
  • 0.5 to 1.0 g/g This level of leakage probably requires medical treatment to protect the kidneys.
  • 1.0 to 3.0 g/g This range predicts that kidney function will likely decline further and definitely needs treatment.
  • Greater than 3.0 g/g This is a sign of significant stress on the kidneys and may lead to rapid decline if not treated aggressively.

Why Reducing Proteinuria Is Important

“Reducing proteinuria to normal levels or the best possible level is crucial to preserving long-term kidney health in IgAN,” says Parikh. Proteinuria is an early warning sign that the kidney filters are under stress or actively inflamed, he says.

EGFR, on the other hand, usually begins to decline later, after the damage has been occurring for some time. Catching and reducing proteinuria early can help protect your eGFR from dropping down the road.

How These Numbers Are Used to Predict Your Future

Although eGFR and uPCR track different markers, healthcare providers look at these two results together to better understand how active IgAN is and how your kidneys may change over time.

These are some common patterns that nephrologists look for, what they often mean, and how they’re usually managed, according to our experts.

UPCR and EGFR Pattern
What It Often Means
How It’s Usually Treated
High uPCR; high or stable eGFR
Your kidneys are still working well, but the filters are under stress. This is often an early stage of disease, but it can progress quickly if not treated.
This is a key window for treatment, with a focus on lowering proteinuria to protect kidney function before eGFR begins to decline. Bringing uPCR below 0.5 g/g can greatly improve the chances of preserving kidney function and avoiding dialysis or kidney transplant.
High uPCR; declining eGFR
This is the most concerning pattern. The filters are damaged, and kidney function is decreasing. Without treatment, further decline can occur.
More aggressive treatment is usually needed. Your care team will likely prescribe several medications and may also begin discussions about planning for treatments like dialysis or a transplant. Kidney function can deteriorate rapidly in this situation.
Low uPCR; low eGFR
The kidneys have lost function, likely from past IgAN activity, but the filters aren’t being actively injured. Low proteinuria is a positive sign, and eGFR is not likely to decline rapidly.
This pattern calls for careful monitoring and protection of the remaining kidney function, as it might still decline gradually due to aging, high blood pressure, or previous damage. Regular blood and urine tests become even more important.
To bring all of this together, some nephrologists use risk prediction tools, like the International IgAN Prediction Tool, which combines eGFR, uPCR, and other clinical factors to estimate the likelihood of needing dialysis or a kidney transplant in the future.

 “These tools help educate the patient on the current status of their IgAN and potential risk for disease progression if we are unable to modify disease course,” says Parikh.
Looking at these predictions can feel overwhelming, but it helps to remember that they’re based on your current numbers and what might happen without intervention. With new medications and targeted therapies becoming available, there are more ways than ever to manage IgAN and help protect your kidneys.

How to Partner With Your Nephrologist

The time you spend with your nephrologist during each medical appointment can be limited. Being proactive about tracking your lab results and preparing questions can help you understand the recommended treatments and be more involved in managing your care. Consider doing the following:

  • Review your lab results before your appointments. Johnson encourages patients to look at their results ahead of time, even if the numbers feel intimidating. You can usually find this information on your online health portal.
  • Ask which numbers should be your focus. It can be overwhelming to look at a long list of lab values. Johnson suggests asking your nephrologist which markers are most important for you, as this can vary from person to person.
  • Track your trends. Look back at your last few results and note how your current eGFR compares with previous values. Do the same with your uPCR. Are they stable, improving, or slowly changing? Track your results in a notebook or on your phone, and include the date of each test to help you notice changes and understand what your provider is watching for.
  • Don’t skip labs or follow-up visits. Many people with IgAN have no symptoms, which can make it tempting to delay testing or skip appointments. Early changes, especially rising proteinuria, are easier to treat when they’re caught sooner, says Johnson.
  • Understand your triggers. Parikh notes that IgAN flares are often triggered by infections in other parts of the body, like a cold or a stomach bug. In this case, there may be blood in your urine (hematuria). If your urine looks darker when you’re sick, it’s a sign that IgAN is more active and you should let your nephrologist know right away.
  • Educate yourself about the disease. Consider using trusted education sources, such as the National Kidney Foundation, patient webinars, or online educational reviews to better understand eGFR, proteinuria, and chronic kidney disease, says Parikh. The more you understand about your disease, the better you can advocate for yourself.

It’s not always obvious what to ask during an appointment, especially when lab results are involved. It’s also common to think of questions only after you’ve already left the office, so it helps to have a few questions ready to help you make the most of the visit. Here are some to consider:

  • What has the trend been for my eGFR and uPCR?
  • What is my target uPCR?
  • Based on my current uPCR, are my medications working well enough or should we consider a different approach?
  • Is my blood pressure on target for protecting my kidneys?
  • Are there any other symptoms or changes I should be watching for before our next visit?
  • How often should I repeat labs based on my current results?
  • What new IgAN treatments am I eligible for?
  • Should we track any other lab values besides eGFR and uPCR?
  • What else can I do to help protect my kidneys?

The Takeaway

  • EGFR estimates how well your kidneys are working overall, with higher numbers meaning better function. Healthcare providers focus on the eGFR trend rather than one test result.
  • UPCR shows how much protein is leaking into your urine. When managing IgA nephropathy, lowering uPCR is one of the most important ways to help protect your kidneys.
  • Healthcare providers use eGFR and uPCR together to determine how active your disease is and make treatment recommendations.
  • Review your lab results before appointments, track your trends, and write down your questions. These steps can help you work more closely with your nephrologist and take an active role in slowing disease progression.
EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
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  5. Understanding Your Lab Results. IgA Nephropathy Foundation.
  6. Sim JJ et al. Progression of Immunoglobulin A Nephropathy (IgAN) in a Hispanic/Latinx Population in the United States. Frontiers in Nephrology. January 8, 2026.
  7. IgA Nephropathy. National Institute of Diabetes and Digestive and Kidney Diseases. September 2022.
  8. Protein in Urine (Proteinuria). Cleveland Clinic. August 2, 2022.
  9. Creatinine. National Kidney Foundation. June 1, 2023.
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  11. Floege J et al. Treatment of Patients with IgA Nephropathy: A Call for a New Paradigm. Kidney International. April 2025.
  12. Kidney Disease: Improving Global Outcomes (KDIGO) IgAN and IgAV Work Group et al. KDIGO 2025 Clinical Practice Guideline for the Management of Immunoglobulin A Nephropathy (IgAN) and Immunoglobulin A Vasculitis (IgAV). Kidney International. October 2025.
  13. Tang C et al. Time-Varying Proteinuria and Progression of IgA Nephropathy: A Cohort Study. American Journal of Kidney Diseases. August 2024.
  14. Faucon AL et al. Albuminuria Predicts Kidney Events in IgA Nephropathy. Nephrology, Dialysis, Transplantation. April 30, 2024.
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Igor Kagan, MD

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Igor Kagan, MD, is an an assistant clinical professor at UCLA. He spends the majority of his time seeing patients in various settings, such as outpatient clinics, inpatient rounds, and dialysis units. He is also the associate program director for the General Nephrology Fellowship and teaches medical students, residents, and fellows. His clinical interests include general nephrology, chronic kidney disease, dialysis (home and in-center), hypertension, and glomerulonephritis, among others. He is also interested in electronic medical record optimization and services as a physician informaticist.

A native of Los Angeles, he graduated cum laude from the University of California in Los Angeles (UCLA) with a bachelor's in business and economics, and was inducted into the Phi Beta Kappa honor society. He then went to the Keck School of Medicine at the University of Southern California (USC) for his medical school education. He stayed at USC for his training and completed his internship and internal medicine residency at the historic Los Angeles County and USC General Hospital. Following his internal medicine residency, Kagan went across town to UCLA's David Geffen School of Medicine for his fellowship in nephrology and training at the UCLA Ronald Reagan Medical Center. After his fellowship he stayed on as faculty at UCLA Health.

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