Immunoglobulin A nephropathy

Immunoglobulin A nephropathy (IgAN) is the most common form of glomerulonephritis worldwide and is a major cause of kidney failure, especially in young adults. It has an individually variable course, with most chronic forms predicting the development of renal failure. There are no well-defined prognostic markers and the international IgAN prediction tool can only be used in the first 2 years after confirmation of the diagnosis. A possible dysregulation of the mucosal immune system seems to be part of the pathophysiology and targeted-release formulation (TRF) budesonide, a budesonide specifically released in the ileum, was approved as the first drug specifically developed for IgAN due to its convincing efficacy. Another new treatment option is sparsentan, a dual angiotensin II and endothelin A receptor antagonist, which convincingly shows a rapid reduction of proteinuria. Many other treatment approaches are under investigation in numerous clinical trials.