[Brussels, Belgium] – KDIGO is pleased to announce the publication of the conference report from the KDIGO Controversies Conference on Therapies Targeting B Cells in Immune-Mediated Kidney Diseases. The conference, held in Panama City, Panama, in June 2025, was co-chaired by Jürgen Floege, MD (Germany), and Brad Rovin, MD (United States), and brought together international experts and patient representatives to examine how advances in B cell biology are reshaping the treatment of immune-mediated kidney diseases.
Published in Kidney International, the report captures the conference’s assessment of current evidence and emerging therapies for targeting B cells across a range of kidney diseases. In a rapidly evolving treatment landscape, advances in understanding B cell biology are leading to the development of increasingly precise therapies, and emerging cell-based approaches are raising the possibility of prolonged treatment-free remission for some patients.
“We are entering a new era in the treatment of immune-mediated kidney diseases,” said Dr. Floege. “Over the past decade, B cell–targeted therapies have transformed care for some diseases and are showing promise in others. At the same time, we are learning that not all B cell depletion is the same. The depth, breadth, and duration of B cell depletion may influence treatment response, helping to explain why some therapies succeed while others have more limited effects.”
The report reviews evidence across IgA nephropathy, membranous nephropathy, podocytopathies, lupus nephritis, and ANCA-associated glomerulonephritis. Conference participants discussed how therapies targeting B cells and plasma cells are expanding treatment options, the growing role of biomarkers to guide patient selection and treatment monitoring, and the need to better understand the level of immune cell depletion required for different diseases. The report also explores emerging therapies, including CAR T cells and other cellular approaches, that may achieve deeper depletion of disease-causing immune cells than conventional therapies.
“One of the central questions explored at the conference was whether the depth of B cell depletion influences clinical outcomes,” said Dr. Rovin. “Emerging therapies are challenging the traditional view that all B cell–targeted approaches work in the same way. By enabling deeper depletion of disease-causing immune cells, these therapies may help us better understand the relationship between immune depletion, disease remission, and long-term outcomes. What we learn could fundamentally change the future of treatment for immune-mediated kidney diseases.”
The report identifies important research priorities, including the development of validated biomarkers to guide therapy selection, optimize treatment intensity and duration, and improve understanding of long-term safety. Patient preferences and shared decision-making are critical when weighing options for management with immune-targeted therapies.
Download the report on the KDIGO and Kidney International websites.
