Treatment and practical considerations of IgA nephropathy

Abstract

IgA nephropathy is a common cause of glomerular disease that may result in kidney failure. Until recently, angiotensin blockade using angiotensin converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARB) were the main treatment options for patients with IgA nephropathy. Newer drugs such as sodium-glucose co-transporter 2 (SGLT2) inhibitors, endothelin angiotensin receptor antagonists (DEARA), endothelin receptor antagonists (ERA), complement inhibitors, targeted release formulation glucocorticoids, and a proliferation-inducing ligand (APRIL) and B cell activation factor (BAFF) inhibitors have shown promise in reducing proteinuria and delaying the progression of IgA nephropathy. In this review, we will explore the latest pharmacological options, their efficacy, and when they should be considered in adult patients with IgA nephropathy.