Background

IgA nephropathy is the most common primary glomerulonephritis worldwide, characterized by mesangial deposition of IgA often accompanied by IgG and C3. Clinical presentation ranges from mild hematuria to rapidly progressive glomerulonephritis, and the disease can progress to end‑stage renal disease within months. Reliable biomarkers to predict therapeutic response are lacking, creating significant challenges in clinical practice.

Study Objective

The study aims to evaluate, using real‑world data, whether an optimized renal‑protective strategy combined with contemporary agents (e.g., SGLT2 inhibitors, endothelin‑1 receptor antagonists) reduces persistent proteinuria and deterioration of renal function in patients with IgA nephropathy. The goal is to confirm the effectiveness of innovative renal‑protective approaches in routine care and to identify risk factors for treatment failure.

Design and Conduct

This is a prospective, real‑life cohort study initiated on 2025‑06‑23 and currently enrolling participants. The sponsor is the French public hospital network. Data collection includes patient clinical characteristics, prior use of renin‑angiotensin system (RAS) blockers, history of steroid and immunosuppressive therapy, and the timing of initiation of SGLT2 inhibitors and endothelin‑1 receptor antagonists. The primary endpoints are persistent proteinuria and the rate of decline in glomerular filtration rate (GFR). An anticipated completion date has not been specified.

Expected Impact

Quantifying the effect of renal‑protective strategies on actual patients will enable updates to treatment guidelines and support the clinical adoption of new therapeutics. Compared with traditional steroid‑centric regimens, this approach may reduce adverse events and provide a robust evidence base for developing personalized treatment strategies.