Rethinking IgAN in Community Nephrology | RKD Show

EPISODE 4

Rethinking IgAN: A Different Perspective From Community Nephrologists

Luis E. Velez, MD is a board-certified community nephrologist in San Antonio, TX, with expertise in hypertension and glomerular disorders.

Jessica Coleman, MD is a board-certified community nephrologist practicing between Savannah, GA, and Charleston, SC, with expertise in hypertension and glomerular disorders.

In this episode, Dr. Velez and Dr. Coleman discuss management of patients with IgA nephropathy from a community nephrologist perspective. They discuss how their management of IgA nephropathy has evolved, highlighting that new data, like the RaDaR study, have been key drivers of change. With greater awareness of the role of proteinuria in IgA nephropathy, they advocate for early and aggressive treatment to avoid long-term complications.

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Episode Summary

“RaDaR taught me that the traditional way of looking at IgA nephropathy is wrong. We realized this is a disease state that absolutely can progress and can progress more rapidly than what we initially appreciated and certainly at a younger age in these patients.” (02:25)

“When we look at patients with proteinuria, even just 0.5 g/d, a third of patients under 40 are going to progress to end-stage kidney disease in ten years [RaDaR].” (04:30)

“With the RaDaR data, we see levels of proteinuria 0.5-0.8 g/d still being significant markers for disease progression.” (08:56)

IgA nephropathy is not a benign disease.
Proteinuria is the most important prognostic indicator of disease progression in IgA nephropathy.
Healthcare professionals should be targeting lower proteinuria goals to achieve complete remission <0.3 g/d.
The updated 2021 KDIGO Guidelines should support clinicians’ decisions to target complete remission.

Disclaimer: Guest speakers of the Rare Kidney Disease Show may be paid consultants of Travere Therapeutics.

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