Two nephropathy experts discuss advancements in immune modulating therapies for IgA nephropathy (immunoglobulin A). Dr Rovin outlines the pathogenic drivers for kidney function loss in IgA, emphasizing four hits to the kidney: overproduction of galactose-deficient IgA, deposition in glomeruli, inflammatory processes, and subsequent kidney damage. The discussion addresses the perception of IgA as a benign disease and highlights a UK study revealing substantial kidney damage even at initial diagnosis.

Dr Rovin challenges the notion that proteinuria is the sole indicator of progressive disease, citing cases with microscopic hematuria and kidney damage. He advocates reevaluating treatment targets beyond reducing proteinuria to one gram a day. Both experts stress the need for a paradigm shift in addressing IgA, especially with the emergence of new drugs. The urgency to reevaluate current practices becomes evident as the conversation underscores the importance of recognizing kidney damage even in the absence of traditional markers.

The dialogue prompts a broader consideration of treatment targets, urging the medical community to explore strategies for patients with varying symptoms and kidney conditions. The anticipation of novel therapies prompts a call for a redefined paradigm in managing IgA nephropathy, signaling a shift in how clinicians approach the disease.

Video synopsis is AI-generated and reviewed by HCPLive editorial staff.