Travere and KDIGO Podcast Collaboration

Conversations in Nephrology: Overview of the Latest Guidance in IgA Nephropathy Management

Episode Summary

In this Travere-sponsored episode of KDIGO Conversations in Nephrology, Dr. Dana Rizk is joined by Dr. Brad Rovin, Co-Chair of the KDIGO Glomerular Disease Guideline Working Group, to examine the updated KDIGO Guideline for IgA nephropathy and the clinical reasoning behind its evolution. As new targeted therapies expand the treatment landscape, the guidance redefines how clinicians assess risk, set treatment goals, and determine when to intervene.

Dr. Rovin discusses why IgA nephropathy should no longer be approached as a “watch-and-wait” condition, the shift toward earlier biopsy at lower proteinuria thresholds, and the updated goals for proteinuria reduction and estimated glomerular filtration rate (eGFR) preservation.

The episode underscores the importance of long-term risk assessment and treatment of both chronic kidney disease and the underlying immunologic process in protecting kidney function over a patient’s lifetime.

Dr. Brad Rovin, MD – Ohio State University, Columbus, OH

Dr. Dana Rizk, MD (host) – University of Alabama at Birmingham, Birmingham, AL

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Key Takeaways

“For the first time in my career as a nephrologist, we actually have targeted therapies for IgA nephropathy. And I think that this has created lots of opportunities for us, but it also has created a considerable amount of confusion
in the community.” (1:38)

“IgA nephropathy is not a benign disease. It’s not a disease that we can watch and wait. There should be a sense of urgency when we see patients with IgA nephropathy to protect the kidney and preserve renal parenchyma.” (2:57)

“When you take the bulk of the data together… you really get the picture that we overestimated, I believe, the amount of proteinuria that was “safe” in IgA nephropathy.” (14:00)

IgA nephropathy should no longer be considered a benign or “watch-and-wait” condition; early action is essential
Evidence shows that even proteinuria levels previously considered “safe” are associated with long-term kidney failure risk
The recommended biopsy threshold has shifted to ≥0.5 g/day to enable earlier diagnosis and risk stratification
Treatment goals have evolved, with greater emphasis on achieving lower proteinuria targets and minimizing long-term eGFR decline
Consider simultaneous management to address both chronic kidney disease and underlying immunologic disease processes

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Disclaimer: This episode of Conversations in Nephrology was supported by Travere Therapeutics and developed by Kidney Disease: Improving Global Outcomes. The opinions presented are those of the individual speakers and not those of Travere Therapeutics. This podcast episode was published on October 2, 2025. Please always consult updated sources for the latest information, as information discussed may have changed since the recording date.

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