Advances in Pharmacotherapy for IgA Nephropathy

IgA肾病(IgAN)是全球最常见的原发性肾小球疾病，约占原发性肾小球肾炎的20%~40%。其病理特征为肾小球系膜区IgA沉积，临床表现为血尿、蛋白尿及进行性肾功能减退。目前，IgA肾病的治疗策略主要包括优化血压控制、减少蛋白尿、抑制炎症和免疫反应等。近年来，随着对IgA肾病发病机制的深入研究，新型靶向药物如补体抑制剂、B细胞靶向治疗及黏膜免疫调节剂等逐渐进入临床研究阶段。本文综述了IgA肾病药物治疗的现状及新型靶向药物的研究进展，以期为临床治疗提供参考。IgA nephropathy (IgAN), the most prevalent primary glomerulonephritis worldwide, accounts for 20%~40% of cases. It is pathologically characterized by mesangial IgA deposition and clinically manifests as hematuria, proteinuria, and progressive renal dysfunction. Current therapeutic strategies focus on optimized blood pressure control, proteinuria reduction, and suppression of inflammatory/immune responses. Recent advances in understanding IgAN pathogenesis have propelled novel targeted agents (e.g., complement inhibitors, B-cell-targeted therapies, and mucosal immunomodulators) into clinical investigation. This review summarizes current pharmacotherapies and emerging targeted treatments, aiming to provide evidence-based references for clinical practice.