KDOQI US Commentary on the KDIGO 2025 Clinical Practice Guideline for the Management of Immunoglobulin A Nephropathy (IgAN) and Immunoglobulin A Vasculitis (IgAV).

The Kidney Disease Outcomes Quality Initiative (KDOQI) convened a work group to review the 2025 KDIGO (Kidney Disease: Improving Global Outcomes) Clinical Practice Guideline for the Management of Immunoglobulin A Nephropathy (IgAN) and Immunoglobulin A Vasculitis (IgAV). The KDOQI work group reviewed the KDIGO guideline statements and practice points and provided perspective for implementation within the context of clinical practice in the United States. Our understanding of the pathophysiology of IgAN has led to several treatment options that are new to this clinical practice guideline. With many ongoing studies on agents with novel therapeutic mechanisms of action, the KDOQI work group acknowledges the challenges in selecting the appropriate disease modifying agents for such a heterogenous disease. In this commentary, the work group addresses the importance of risk stratification of IgAN while emphasizing the novel therapeutic options that are now available to prevent disease progression.