Near-Term Priorities for Transforming Clinical Practice in IgA Nephropathy

Led by the moderator, the nephrologists examined a potential shift toward earlier identification and risk stratification of IgA nephropathy, with routine use of proteinuria and eGFR trends to guide timely initiation of disease-modifying therapy rather than prolonged observation. Broader adoption of SGLT2 inhibitors and targeted agents as foundational therapy—rather than reserving them for late-stage disease—would better reflect emerging evidence and updated KDIGO principles. I also anticipate movement away from reflexive systemic steroid use toward steroid-sparing, mechanism-based treatment pathways tailored to individual risk profiles. Greater integration of pharmacists and multidisciplinary care teams should improve access navigation, adherence, and safety monitoring for these chronic therapies. Standardized treatment algorithms and electronic health record prompts could help close the gap between clinical trial data and real-world practice. In addition, increased participation in registries and real-world evidence generation will be critical to refining sequencing strategies and demonstrating long-term kidney protection. Ultimately, the goal is a proactive, personalized care model that slows progression earlier and reduces the need for dialysis or transplantation.

Throughout the conversation, the experts provide a comprehensive reflection on the field and the factors that may shape how clinicians approach care moving forward.

Thank you for watching this AJMC Insights series on IgA nephropathy. Please subscribe to our newsletter for information on upcoming video series.