IgA nephropathy is the most common primary glomerulonephritis, yet it had no disease-specific therapy until 2021, and 30-40% of patients still progress to kidney failure.

IgA nephropathy is a primary glomerular disease driven by circulating galactose-deficient IgA1: autoantibodies form immune complexes that deposit in the glomerular mesangium, activate complement and drive progressive kidney injury. It is the most common biopsy-proven primary glomerulonephritis. In a large, racially and ethnically diverse US population, adult incidence ran roughly 1.29 to 2.2 new cases per 100,000 per year, highest among patients of Asian ancestry and lowest among Black patients. Because a confirmed diagnosis requires a kidney biopsy, milder disease managed simply as chronic kidney disease without biopsy goes uncounted, so the diagnosed pool understates true prevalence.

The disease is slow but rarely benign. Between 30% and 40% of patients progress to end-stage kidney disease over 20 to 30 years, and registry data put median kidney survival at roughly 11 years from diagnosis for patients under nephrology follow-up. Proteinuria and eGFR trajectory are the validated markers of long-term outcome, and that evidence base underwrote a fast-moving therapeutic shift: from renin-angiotensin-system blockade plus an SGLT2 inhibitor as the supportive-care backbone to five FDA-approved disease-modifying agents spanning four mechanisms, approved between 2021 and 2026.

The therapeutic shift outpaced the diagnostic pathway that still gates it.

Five questions this report answers:

Q1 - How large is the US IgAN population, and how much disease does the biopsy requirement miss?

Q2 - How do kidney biopsy and the Oxford MEST-C classification define IgAN risk?

Q3 - How does the 2021-2026 approval wave change management alongside KDIGO 2025 guidance?

Q4 - How does IgAN incidence vary by race and ethnicity in the US?

Q5 - What share of IgAN patients progress to kidney failure over time?

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Live report page:  https://axlrx.ai/iga-nephropathy/disease-landscape/

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Mike || Global Pharma Commercial Marketing Head

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