Mistaken for a UTI: Diagnosing IgA Nephropathy, With Gaia Coppock, MD

One interesting take-home point is how nonspecific some of the presenting symptoms can be. People with rare diseases tend to have a lot of false starts before something is actually found, because common things being common, it's not the first thing that most people think about.

Gaia Coppock, MD, is an associate professor of clinical medicine in the Division of Renal-Electrolyte and Hypertension and an attending physician at the Hospital of the University of Pennsylvania in Philadelphia. She directs the hospital's Glomerular Disease Clinical Research Program and its Kidney Biopsy Group, and directs the Lupus Nephritis Program at the University of Pennsylvania School of Medicine. She discussed the findings and what they mean for nephrology practice in an interview with HCPLive.

A poster presented at GlomCon 2026, the annual meeting for glomerular disease specialists held in Maui, Hawaii, put new numbers behind a familiar concern in IgA nephropathy (IgAN): symptom-driven delays between first presentation and diagnosis. The Vertex Pharmaceuticals-sponsored study paired 20 qualitative interviews with a 106-patient survey of the IgAN journey. It builds on recent HCPLive coverage of diagnostic gaps in IgAN.

Patients most often presented with hematuria or fatigue, symptoms Coppock said are easy to miss or misattribute; hematuria, for example, is frequently mistaken for a urinary tract infection. Abnormal labs, including elevated urine protein (82%) and hematuria (70%), were usually what triggered a nephrology referral, and wait times stretching toward a year can put a patient's diagnosis roughly two years behind symptom onset.

Coppock noted once patients reach a nephrologist, the workup typically moves quickly, but many still described feeling confused after diagnosis and turned to the internet or patient advocacy groups to fill gaps, even though about 85% named their doctor as their primary source of information, and 57% said they would rather get it from their nephrologist specifically.

The survey also found a gap between what patients want from treatment and what they feel they're getting: 80% wanted symptoms stopped, but only 49% felt therapy delivered, with similar shortfalls for slowing kidney function loss (78% vs 50%) and delaying dialysis (75% vs 50%). Closing this gap carries real stakes: time-averaged proteinuria above 0.5 g/day has been linked to a higher risk of kidney failure in adults with IgAN.²

Her message to primary care: even low suspicion for IgAN warrants a urine check and follow-up, because earlier recognition offers more treatment options and, in her view, more hope for preserving kidney function.

Editor’s Note: Coppock reports relevant disclosures with Aurinia Pharmaceuticals and Travere Therapeutics.

References:

1. Bensouda M, Wade B, Burns J, et al. IgA Nephropathy Patient Experience: A Qualitative and Quantitative Mixed-Methodology Study. Poster presented at: GlomCon 2026; August 3-7, 2026; Maui, HI.

2. Shah A, Gagnon-Sanschagrin P, Bedard J, et al. Time-averaged proteinuria ≤0.5 g/day is associated with kidney failure in adult patients with IgA nephropathy in the US. Poster presented at: National Kidney Foundation Spring Clinical Meetings; 2026; New Orleans, LA.