The KDIGO 2025 Clinical Practice Guideline for the Management of IgA Nephropathy (IgAN) and IgA Vasculitis (IgAV), together with its Executive Summary, was published in September 2025 in Kidney International. Co-chaired by Jürgen Floege, MD (Germany) and Brad Rovin, MD (United States), this guideline updates and expands upon the IgAN chapter of the KDIGO 2021 Clinical Practice Guideline for the Management of Glomerular Diseases.
IgAN is the most common primary glomerular disease and a leading cause of chronic kidney disease and kidney failure. IgAV, historically known as Henoch–Schönlein purpura, can also result in significant kidney damage, particularly in children. The 2025 guideline integrates evidence from randomized controlled trials through August 2024 to provide the most current recommendations on diagnosis, prognosis, and treatment.
The guideline addresses diagnostic evaluation, risk stratification, supportive care, immunosuppressive and targeted therapies, and special considerations for children, pregnancy, and patients with rapidly progressive disease. Treatment recommendations emphasize both the prevention of IgA-containing immune complex injury and the management of kidney damage, with detailed guidance on therapies including ACE inhibitors or ARBs, targeted-release budesonide (Nefecon), sparsentan, and sodium-glucose cotransporter-2 inhibitors.
Developed using the GRADE methodology, the guideline provides both graded recommendations and consensus-based practice points, supported by practical tools and resources to aid implementation. It also highlights ongoing knowledge gaps and sets out a research agenda to guide future updates, while underscoring the importance of global equity in access to new therapies.
Recognizing the rapid pace of discovery, KDIGO is committed to updating this guideline on an ongoing basis so that clinicians, patients, and policymakers worldwide have access to timely, evidence-based strategies to preserve kidney function and improve outcomes in IgAN and IgAV.
Key Messages from KDIGO IgAN Experts (2025)
KDIGO 2025 IgAN Guideline Key Messages and Implications with Dr Hernán Trimarchi
Disease Pathophysiology, Treatments, and Therapies on the Horizon with Dr Vivek Jha
Management Challenges in Special IgAN Populations with Dr Adrien Liew
(2025) – Treatment of Patients with IgA Bephropathy: A Call for a New Paradigm
(2024) KDIGO IgA Nephropathy Infographics
Russian – KDIGO 2025 IgAN Guideline Key Takeaways
Топ-12Ключевых положений Клинических Практических Рекомендаций KDIGO 2025 по ведению IgAНефропатии (IgА-Н)
Russian – KDIGO 2025 IgAV Guideline Key Takeaways
Топ-10 Ключевых положений Клинических Практических Рекомендаций KDIGO 2025 по ведению IgAВаскулита (IgА-В)
DISCLAIMER: USE OF THE CLINICAL PRACTICE GUIDELINES
This Clinical Practice Guideline is based upon the best information available at the time of publication. The recommendations are designed to provide information and assist decision-making. They are not intended to define a standard of care, and should not be construed as one. Neither should they be interpreted as prescribing an exclusive course of management. Variations in practice will inevitably and appropriately occur when clinicians take into account the needs of individual patients, available resources, and limitations unique to an institution or type of practice. Every health care professional making use of this Guideline is responsible for evaluating the appropriateness of applying them in the setting of any particular clinical situation. The recommendations for research contained within this document are general and do not imply a specific protocol.
