Edward Skolnik, MD

The panel discusses how clinicians assess progression in IgA nephropathy and the importance of recognizing high-risk patients early. They emphasize that proteinuria is a central prognostic marker, and that achieving sustained reduction is critical. However, they note that ongoing eGFR decline, even when proteinuria appears improved, signals continued immune-mediated injury and should prompt re-evaluation. The group then addresses diagnostic challenges, including the fact that many patients first present after significant kidney damage has already occurred. To improve early detection, they support lowering the biopsy threshold to persistent proteinuria around 0.5 g/day, particularly when accompanied by hematuria. Increased awareness among primary care clinicians is highlighted as essential for earlier referral. Finally, the discussion includes the role of the RaDaR Registry, which collects long-term real-world data to help identify progression patterns and refine risk stratification. Overall, the segment underscores the need for early diagnosis and vigilant monitoring.

RaDaR Insights on Proteinuria, eGFR Decline, and Diagnostic Challenges in IgAN

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In this segment, the panelists discuss IgA Nephropathy, a glomerular disease primarily affecting young adults in their 20s and 30s. The condition has a slight predilection for males and Southeast Asians. Patients typically present asymptomatically with blood or protein in urine, or with gross hematuria following a respiratory tract infection. Less commonly, patients may develop severe nephrotic syndrome. Clinicians are most concerned with proteinuria and kidney function. Patients with proteinuria exceeding 0.5 grams are considered at risk for disease progression. The panel emphasizes that diagnoses often occur too late, with patients already having lost nearly half their kidney function. This is particularly critical because these young patients have decades ahead of them, and even small annual kidney function losses can lead to end-stage kidney disease, potentially requiring dialysis. The early detection and monitoring of these patients are crucial for preserving long-term kidney health.

Clinical and Laboratory Findings Suggestive of IgA Nephropathy (IgAN)

In this segment, the panelists discuss IgA Nephropathy, a glomerular disease primarily affecting young adults in their 20s and 30s. The condition has a slight predilection for males and Southeast Asians. Patients typically present asymptomatically with blood or protein in urine, or with gross hematuria following a respiratory tract infection. Less commonly, patients may develop severe nephrotic syndrome.

Clinicians are most concerned with proteinuria and kidney function. Patients with proteinuria exceeding 0.5 grams are considered at risk for disease progression. The panel emphasizes that diagnoses often occur too late, with patients already having lost nearly half their kidney function. This is particularly critical because these young patients have decades ahead of them, and even small annual kidney function losses can lead to end-stage kidney disease, potentially requiring dialysis. The early detection and monitoring of these patients are crucial for preserving long-term kidney health.

In this segment, the panelists discuss IgA Nephropathy, a glomerular disease primarily affecting young adults in their 20s and 30s. The condition has a slight predilection for males and Southeast Asians. Patients typically present asymptomatically with blood or protein in urine, or with gross hematuria following a respiratory tract infection. Less commonly, patients may develop severe nephrotic syndrome.
Clinicians are most concerned with proteinuria and kidney function. Patients with proteinuria exceeding 0.5 grams are considered at risk for disease progression. The panel emphasizes that diagnoses often occur too late, with patients already having lost nearly half their kidney function. This is particularly critical because these young patients have decades ahead of them, and even small annual kidney function losses can lead to end-stage kidney disease, potentially requiring dialysis. The early detection and monitoring of these patients are crucial for preserving long-term kidney health.


Edward Skolnik, MD

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