The Cutting Edge: A Clinicopathology Minireview of Immunoglobulin A Nephropathy

Recent years have seen an explosion of interest in the pathogenesis and therapy of immunoglobulin A nephropathy (IgAN). Large cohort studies have facilitated improvements in disease classification and prognosis, including the establishment and validation of a standard pathological classification, the Oxford classification. Landmark treatment studies published in the past several years have solidified a basic therapeutic approach, emphasizing the value of adding immunomodulatory drugs to supportive care for aggressive disease. There are currently a large number of therapies with diverse mechanisms of action in active development for IgAN, promising at least to enhance our understanding of key pathogenic pathways and, at best, to eventually prove useful in slowing or stopping the progression of IgAN. In this cutting-edge feature, we use a clinical case to review and discuss the current standard of care in the diagnosis and treatment of IgAN, as well as to highlight emerging approaches to treatment.