How should we approach the treatment of IgAN in 2025?

We have seen a welcomed explosion in clinical trial ac vity in IgA nephropathy (IgAN) over the past few years, and in tandem, have had the first ever drugs approved for the treatment of IgAN by drug regulators across the globe.What had been an aspira on un l very recently is rapidly becoming a reality: the ability to offer our pa ents truly disease modifying therapies that address the fundamental immune dysregula on that drives IgAN.The availability of these new treatments is now challenging our tradi onal approach to the treatment of this immune complex mediated glomerular disease.In this NDT supplement we will discuss the rapidly evolving therapeu c landscape in IgAN and how these new therapies are likely to be rapidly integrated into the clinical management of pa ents living with IgAN.IgA nephropathy is a benign glomerular disease-why do we need all these new treatments?IgA nephropathy has tradi onally been regarded as a largely benign, slowly progressive glomerular disease in which the risk of kidney failure was low, with few pa ents progressing to the point of needing a kidney transplant or dialysis (1).Recently published data challenges this dogma and actually suggest that most pa ents diagnosed today are likely to develop kidney failure in their life me if we do not change the way we treat them (2), (3), (4).It is indeed true that in the past pa ents who had a kidney biopsy for isolated nonvisible