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IgA Nephropathy: Mechanisms, Risk Stratification, and Precision Therapy.
1Department of Internal Medicine, University of Jeddah, Jeddah 21493, Saudi Arabia.
Diagnostics (Basel, Switzerland)
|May 13, 2026
Summary
IgA nephropathy, a common kidney disease, requires personalized risk assessment and management. Current treatments focus on supportive care, with emerging therapies offering new hope for patients with persistent proteinuria.
Area of Science:
- Nephrology
- Immunology
- Genetics
Background:
- IgA nephropathy (IgAN) is the most common primary glomerulonephritis globally.
- It is a leading cause of chronic kidney disease (CKD) and kidney failure.
- IgAN exhibits geographic and ancestral variations, with diverse clinical courses.
Purpose of the Study:
- To review the multi-hit model for IgA nephropathy risk stratification.
- To discuss current management strategies and emerging therapies for IgAN.
- To identify implementation gaps in IgAN care.
Main Methods:
- Longitudinal risk assessment integrating proteinuria and eGFR.
- Incorporation of Oxford MEST-C classification, prediction tools, biomarkers, and multi-omics.
- Review of current and emerging therapeutic strategies.
Main Results:
- Risk stratification involves monitoring proteinuria and eGFR trajectories.
- Optimized supportive care includes blood pressure control, RAS blockade, sodium restriction, and SGLT2 inhibitors.
- Immunomodulatory therapies like corticosteroids and budesonide are options for high-risk patients.
Conclusions:
- Personalized risk stratification and optimized supportive care are crucial for IgAN management.
- Emerging therapies targeting BAFF/APRIL, complement, and endothelin pathways show promise.
- Gaps remain in surrogate endpoints, long-term data, and evidence for special populations.
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