Travere and KDIGO Podcast Collaboration

Conversations in Nephrology: Treatment Revolution in IgA Nephropathy

Episode Summary

In this Travere-sponsored episode of KDIGO Conversations in Nephrology, Dr. Dana Rizk speaks with Dr. Shikha Wadhwani about the scientific advances that have transformed the treatment landscape for IgA nephropathy. Dr. Wadhwani describes how improved understanding of disease pathophysiology has reshaped therapeutic strategies, moving beyond supportive care toward the integration of targeted interventions that address underlying disease drivers.

The discussion highlights how decades of global research and recent clinical trial successes have led to a growing armamentarium of therapies, including sparsentan, a Dual Endothelin Angiotensin Receptor Antagonist (DEARA), targeted release budesonide, and SGLT2 inhibitors. Dr. Wadhwani emphasizes the importance of early diagnosis, proactive multitargeted treatment approaches, and shared decision-making with patients as the field continues to rapidly evolve.

Dr. Shikha Wadhwani, M.D., M.S., FASN – University of Texas Medical Branch, Galveston, TX

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

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Key Takeaways

“There’s really been like a seismic shift in the treatment paradigm, really based on our improved understanding of the disease, the risks associated with the disease, and as we’re all excited about, new available treatment options.” (1:30)

“We’re truly in the midst of a revolution in IgAN and this is really due to decades of global research [… ] and the landmark success in the Kidney Health Initiative, which established endpoints for clinical trials in IgA nephropathy.” (13:08)

“There are […] far too many people with this disease ending up needing dialysis or a kidney transplant. […] Let’s seize the moment […] shorten the time to diagnosis, and then once we have a diagnosis, we really need to change our mindset to start with a multitargeted approach to this disease and eliminate any sort of therapeutic inertia we may have.” (13:37)

IgA nephropathy treatment has rapidly evolved since the KDIGO 2021 guideline, with multiple new targeted therapies now available
Decades of global research and landmark clinical trial progress have driven this revolution in IgA nephropathy management
Advances in understanding the pathophysiology have shifted management toward addressing underlying disease drivers, not just supportive care
Patients remain at significant lifetime risk of kidney failure even at proteinuria levels that were traditionally thought to be safe or “low risk”
Treatment decisions should be individualized, emphasizing shared decision-making and a proactive, multitargeted approach to reduce therapeutic inertia

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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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