The Impact of Underdiagnosis and a Pivotal Moment in Care

IgA nephropathy (IgAN) remains underdiagnosed due to its often subtle and nonspecific presentation, with many patients experiencing mild or intermittent symptoms such as microscopic hematuria or low-grade proteinuria. These findings may be overlooked or attributed to less serious conditions, delaying referral to nephrology and definitive diagnosis, which typically requires a kidney biopsy. Additionally, slow disease progression can mask underlying kidney damage for years. This is a critical time in IgAN care as growing awareness of the disease, advances in risk stratification, and the emergence of novel therapies are reshaping the treatment landscape. Earlier identification of at-risk patients now has greater clinical relevance, as timely intervention may help slow progression and preserve kidney function. Recognizing and addressing underdiagnosis is essential to improving outcomes in this evolving era of IgAN management.