2025 KDIGO Guideline Update for IgAN

The KDIGO 2025 guidelines update emphasizes a more aggressive approach to treating IgA Nephropathy. The experts highlight key changes, including recognizing a broader range of patients as high-risk and lowering the proteinuria threshold for intervention to 500 milligrams. The guidelines now advocate for earlier biopsy and more comprehensive treatment strategies.

The panelists stress the importance of ambitious treatment goals, including reducing eGFR decline to less than one milliliter per minute per year and targeting proteinuria below 0.5 grams daily, ideally below 0.3 grams. The panel agrees that these goals were unimaginable just five years ago.

The guidelines recommend simultaneous treatment approaches, moving away from sequential therapies. They encourage targeting multiple disease mechanisms, including supportive care and immunological interventions. The experts emphasize the need to treat IgA Nephropathy as a lifelong condition, with the ultimate goal of protecting kidney function and avoiding dialysis.