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Opinion|Videos|February 20, 2026

Positioning Emerging Targeted Therapies in the Evolving IgA Nephropathy Treatment Paradigm

Learn how targeted-release budesonide treats IgA nephropathy, cutting proteinuria and slowing GFR decline with fewer steroid side effects.

Episodes in this series

This episode, titled Positioning Emerging Targeted Therapies in the Evolving IgA Nephropathy Treatment Paradigm, features nephrology experts discussing the following critical question:

When are you utilizing endothelin antagonists, complement inhibitors and novel therapies like BAFF/APRIL blockers in your clinical practice?

Led by Dr. Gerald Appel, Dr. Luis Sanchez Russo examined endothelin receptor antagonists, which are often considered after optimization of supportive care, particularly in patients with persistent proteinuria and evidence of ongoing nephron loss despite ACEi or ARB therapy and SGLT2 inhibition. These agents primarily address downstream pathways of kidney injury by reducing intraglomerular pressure and fibrosis, making them well suited for patients with progressive chronic disease features. Complement inhibitors are typically utilized in patients with higher-risk IgA nephropathy who demonstrate signs of active immune-mediated injury, especially when biopsy or clinical features suggest complement pathway activation. Their use is often guided by disease severity, rate of progression, and lack of adequate response to conventional or supportive therapies. Novel therapies targeting BAFF and APRIL are increasingly being considered earlier in the treatment algorithm for patients with persistent proteinuria and immun

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

In the next episode, Assessing Long-Term Renal Outcomes and Kidney Failure Risk Reduction in IgA Nephropathy, panelists will continue their discussion on IgA nephropathy and highlight the impact of emerging and established therapies on long-term progression to kidney failure and the need for dialysis, with a focus on outcome-driven evidence. It also reviews insights from studies such as RADAR and Kaiser Permanente that inform KDIGO-aligned kidney function thresholds and treatment timing.