Iga-Nephropathy

IgA vasculitis and IgA nephropathy share HLA susceptibility, 21 GWAS risk loci, elevated Gd-IgA1 and renal biopsies that cannot be told apart — yet IgAN now has five approved therapies and IgAV has none, because IgAV patients were excluded from every trial that delivered them. What changes today: KDIGO 2025 lowers the treatment threshold to 0.5 g/day of proteinuria, and it explicitly covers IgA vasculitis.

Final 24-month data from APPLAUSE-IgAN: the oral factor B inhibitor iptacopan roughly halved the rate of eGFR decline in high-risk IgA nephropathy (−3.10 vs −6.12 ml/min/1.73 m²/year) and cut hard kidney-failure events from 33.5% to 21.4%, converting an accelerated approval based on proteinuria into evidence on preserved kidney function — with serious infection the trade-off to manage.