Pathogenesis and treatment of IgA nephropathy

Introduction

IgA nephropathy [IgAN] is a major cause of end-stage renal disease [ESRD] and is typically indolent progressing to ESRD over years, although the natural history is very variable with a minority developing rapid progression over months to ESRD, and an important proportion of patients not progressing at all during prolonged follow up.

Pathogenesis

The deposition of mesangial polymeric IgA1 [pIgA1] and the initiation of glomerular inflammation and injury are events specific to IgAN. Subsequent glomerular and tubulo-interstitial injury proceeds by mechanisms generic to most forms of chronic glomerular disease.