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The kidneys are intricate organs with millions of working units known as nephrons. Each nephron features two major structures: the renal corpuscle, which facilitates blood plasma filtration, and the renal tubule, which handles the glomerular filtrate. Blood supply is directly linked to the nephrons. The renal corpuscle consists of the glomerulus, a capillary network, and the Bowman's capsule, a double-walled epithelial structure that encases the glomerulus. The filtering of blood plasma...

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Related Experiment Video

Updated: Jul 2, 2025

Detection of MicroRNA Expression in the Kidneys of Immunoglobulin A Nephropathic Mice

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Published on: July 8, 2020

Refractory IgA Nephropathy: A Challenge for Future Nephrologists.

Vincenzo Di Leo¹, Francesca Annese¹, Federica Papadia¹

¹Department of Precision and Regenerative Medicine and Ionian Area-Nephrology, Dialysis and Transplantation Unit, University of Bari "Aldo Moro", 70124 Bari, Italy.

Medicina (Kaunas, Lithuania)

|February 24, 2024

Summary

IgA nephropathy (IgAN) is a leading cause of kidney failure. This review explores novel treatments beyond supportive care and steroids for IgAN patients with refractory disease.

Keywords:

SGLT2 inhibitors clinical trials complement cascades fecal microbiota transplantation new drugs refractory IgA nephropathy

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Area of Science:

Nephrology
Immunology

Background:

IgA nephropathy (IgAN) is the most common primary glomerulonephritis and a major cause of end-stage kidney disease (ESKD).
Current management focuses on blood pressure control and proteinuria reduction using renin-angiotensin system (RAS) inhibitors.
Glucocorticoids are recommended for high-risk patients per KDIGO guidelines, but treatment resistance occurs.

Approach:

This systematic review searched the PubMed database for emerging therapeutic strategies for IgAN.
The review focuses on treatments for patients with refractory IgAN, defined by persistent proteinuria or intolerance to standard therapies.
Investigated therapies include SGLT2 inhibitors, endothelin receptor blockers, and novel immunomodulatory agents.

Key Points:

Refractory IgAN poses a significant challenge, necessitating alternative treatment options.
Emerging therapies target diverse pathways including SGLT2 inhibition, endothelin receptor blockade, and B cell modulation.
Investigated strategies also include budesonide, fecal microbiota transplantation, and complement component blockade.

Conclusions:

This review highlights promising therapeutic avenues for IgAN patients unresponsive to conventional treatments.
Further research is crucial to establish the efficacy and safety of these novel strategies in managing IgAN.
Exploring these advanced therapies may offer new hope for preserving kidney function in IgAN patients.