Evolving Management and Pathogenesis of IgA Nephropathy

The treatment landscape for IgA nephropathy (IgAN) has shifted significantly from primarily supportive care to the development of targeted therapies. Historically, management focused on controlling blood pressure, reducing proteinuria, and mitigating kidney damage with general measures such as renin–angiotensin system blockade. Advances in understanding disease mechanisms have enabled the emergence of therapies aimed at specific pathogenic pathways, offering the potential for more precise and effective interventions. IgAN is characterized by the deposition of IgA-containing immune complexes in the glomeruli, leading to inflammation and progressive kidney injury. Clinically, patients often present with hematuria, proteinuria, or incidental findings on routine labs, but disease progression is highly variable—ranging from stable kidney function over decades to rapid progression toward end-stage renal disease. Recognizing this variability is critical for risk stratification and individualized treatment planning