IgA Nephropathy: Recognition and Management

Ali Gharavi, MD


October 14, 2021

IgA nephropathy, the most common form of glomerular nephropathy, is caused by deposits of the protein immunoglobulin A (IgA) in the kidney, and can lead to end-stage renal disease. It can present in patients in their mid-twenties to mid-thirties and can coincide with mucosal infection, either respiratory or gastrointestinal. About 20% of patients progress to kidney failure within 10-20 years.

Clinical risk factors for progression include diminished kidney function at diagnosis, proteinuria, hypertension, and histopathologic evidence of kidney injury.

There are currently no specific treatments for IgA nephropathy; therefore, management relies on controlling all factors that can worsen kidney disease, such as hypertension, hyperglycemia, obesity, and proteinuria.

The best initial therapy is with renin-angiotensin blockade, but there are currently many clinical trial options for patients.

In this ReCAP, Dr Ali Gharavi, professor of nephrology and hypertension, and chief of the department of nephrology at Columbia University Irving Medical Center/NewYork-Presbyterian Hospital, reviews the diagnosis and management of IgA nephropathy.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.