nidНефрология и диализNephrology and Dialysis1680-44222618-9801Российское диализное общество10.28996/2618-9801-2025-3-242-257nid-3873Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESIgA нефропатия: особенности клинического течения и прогнозIgA nephropathy: clinical course characteristics and prognosishttps://orcid.org/0000-0001-5271-1902ЗубкинМ. Л.ZubkinM. L.

Зубкин Михаил Леонидович – д-р мед. наук, профессор, г.н.с., руководитель клинико-диагностического отдела ФБУН МНИИЭМ им. Г.Н. Габричевского Роспотребнадзора; профессор кафедры терапии неотложных состояний филиала ВМедА им. С.М. Кирова Минобороны России; врач-нефролог ГБУЗ «МКНИЦ БОЛЬНИЦА 52 ДЗМ».

125212, Москва, ул. адмирала Макарова, д. 10; 107392, Москва, ул. Малая Черкизовская, д. 7; 123182, Москва, ул. Пехотная, д. 3

Mikhail L. Zubkin.

125212, 10, admiral Makarov str., Moscow; 7, Malaya Cherkizovskaya str., 107392, Moscow; 3, Pekhotnaya str., 123182, Moscow

m-zubkin@yandex.ruhttps://orcid.org/0000-0003-1051-2897ЧервинкоВ. И.ChervinkoV. I.

Червинко Валерий Иванович – канд. мед. наук, доцент, в.н.с. ФБУН МНИИЭМ им. Г.Н. Габричевского Роспотребнадзора; преподаватель кафедры терапии неотложных состояний филиала ВМедА им. С.М. Кирова Минобороны России; врач-нефролог ГБУЗ «МКНИЦ БОЛЬНИЦА 52 ДЗМ».

125212, Москва, ул. адмирала Макарова, д. 10; 107392, Москва, ул. Малая Черкизовская, д. 7; 123182, Москва, ул. Пехотная, д. 3

Valeriy I. Chervinko.

125212, 10, admiral Makarov str., Moscow; 7, Malaya Cherkizovskaya str., 107392, Moscow; 3, Pekhotnaya str., 123182, Moscow

dok534@yandex.ruСолдатовД. А.SoldatovD. A.

Солдатов Данил Аскерович – м.н.с. клинико-диагностического отдела ФБУН МНИИЭМ им. Г.Н. Габричевского Роспотребнадзора; врач-нефролог ГБУЗ «МКНИЦ БОЛЬНИЦА 52 ДЗМ».

125212, Москва, ул. адмирала Макарова, д. 10; 123182, Москва, ул. Пехотная, д. 3

Danil A. Soldatov.

125212, 10, admiral Makarov str., Moscow; 3, Pekhotnaya str., 123182, Moscow

danil.soldatov.1996@mail.ruhttps://orcid.org/0000-0002-0402-8348СтоляревичЕ. С.StolyarevichE. S.

Столяревич Екатерина Сергеевна – д-р мед. наук, профессор кафедры нефрологии ФГБОУ ВО «РосУниМед» МЗ РФ; врач-патологоанатом отделения патологической анатомии ГБУЗ «ГБУЗ «МКНИЦ БОЛЬНИЦА 52 ДЗМ».

123182, Москва, ул. Пехотная, д. 3; 127994, Москва, ГСП-4, Рахмановский пер, д. 3

Ekaterina S. Stolyarevich.

3, Pekhotnaya str., 123182, Moscow; 3, Rachmanovsky alley, Moscow, 127994

Stolyarevich@yandex.ruhttps://orcid.org/0000-0002-8396-1936КрюковЕ. В.KryukovE. V.

Крюков Евгений Владимирович – академик РАН, д-р мед. наук, начальник ВМедА им. С.М. Кирова Минобороны России.

194044, Санкт-Петербург, ул. Академика Лебедева, д. 6

Evgeniy V. Kryukov.

6, Akad. Lebedeva str., 194044, St. Petersburg

evgeniy.md@mail.ruhttps://orcid.org/0000-0002-6086-5220ФроловаН. Ф.FrolovaN. F.

Фролова Надия Фяатовна – канд. мед. наук, заместитель главного врача по нефрологической помощи ГБУЗ «МКНИЦ БОЛЬНИЦА 52 ДЗМ»; доцент кафедры нефрологии ФГБОУ ВО «РосУниМед» МЗ РФ.

123182, Москва, ул. Пехотная, д. 3; 127994, Москва, ГСП-4, Рахмановский пер, д. 3

Nadiya F. Frolova.

3, Pekhotnaya str., 123182, Moscow; 3, Rachmanovsky alley, Moscow, 127994

nadiya.frolova@yandex.ruФБУН «Московский научно-исследовательский институт эпидемиологии и микробиологии имени Г.Н. Габричевского» Роспотребнадзора; Филиал ФГБВОУ ВО «Военно-медицинская академия имени С.М. Кирова» МО РФ в г. Москве; ГБУЗ города Москвы «Московский клинический научно-исследовательский центр Больница 52 Департамента здравоохранения города Москвы»РоссияG.N. Gabrichevsky Research Institute for Epidemiology and Microbiology; Branch of the S.M. Kirov Military Medical Academy; Moscow Clinical Research Center Hospital 52Russian FederationФБУН «Московский научно-исследовательский институт эпидемиологии и микробиологии имени Г.Н. Габричевского» Роспотребнадзора; ГБУЗ города Москвы «Московский клинический научно-исследовательский центр Больница 52 Департамента здравоохранения города Москвы»РоссияG.N. Gabrichevsky Research Institute for Epidemiology and Microbiology; Moscow Clinical Research Center Hospital 52Russian FederationГБУЗ города Москвы «Московский клинический научно-исследовательский центр Больница 52 Департамента здравоохранения города Москвы»; Кафедра нефрологии, ФГБОУ ВО «Российский университет медицины» Минздрава РоссииРоссияMoscow Clinical Research Center Hospital 52; Russian University of Medicine (ROSUNIMED), Chair of NephrologyRussian FederationФГБВОУ ВО «Военно-медицинская академия имени С.М. Кирова» МО РФРоссияS.M. Kirov Military Medical AcademyRussian Federation202504102025273242257Copyright © Зубкин М.Л., Червинко В.И., Солдатов Д.А., Столяревич Е.С., Крюков Е.В., Фролова Н.Ф., 20252025Зубкин М.Л., Червинко В.И., Солдатов Д.А., Столяревич Е.С., Крюков Е.В., Фролова Н.Ф.Zubkin M.L., Chervinko V.I., Soldatov D.A., Stolyarevich E.S., Kryukov E.V., Frolova N.F.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.nephro.ru/jour/article/view/3873

IgA нефропатия (IgAН), впервые описанная в 1968 году, является самым часто встречающимся в мире первичным гломерулонефритом. Распространенность заболевания наиболее высока в Азии по сравнению с Европой и Северной Америкой; при этом допускается возможность гиподиагностики в таких регионах, как Африка.

Дебютируя, как правило, у пациентов молодого возраста, она становится одной из наиболее важных причин развития терминальной стадии хронической болезни почек, требующей применения заместительной почечной терапии. В то же время, недавние исследования указывают на рост заболеваемости среди пожилых людей, часто с более тяжелыми исходами.

Течение и исход заболевания в настоящее время трудно прогнозируем в связи с выраженным полиморфизмом клинических проявлений и морфологической картины, что, по-видимому, связано с широким спектром возможных вариантов этиопатогенеза. В представленном обзоре литературы рассматриваются современные подходы к оценке клинических симптомов и биомаркеров в аспекте их связи с патоморфологическими чертами и прогнозом IgAН. В течение последних лет выраженная протеинурия признавалась фактически единственным предиктором неблагоприятного исхода и показанием к активному лечению. Однако относительно недавно были получены данные, свидетельствующие о значимости протеинурии любого уровня, а также стабильной микрогематурии для прогноза IgAН, что представляется серьезным основанием для изменения парадигмы терапии заболевания. Отражены две принципиально разные позиции в давней, но продолжающейся до настоящего времени, дискуссии в отношении прогностической роли макрогематурии. В обзоре также обсуждается значение нефротического синдрома в отношении прогноза в зависимости от специфических гистологических паттернов, такими как IgAН – болезнь минимальных изменений или эндокапиллярная пролиферация. На основе литературных материалов анализируются клинические варианты течения IgAН и их связь с исходом болезни. Представлены первые результаты применения кластерного анализа, позволившего выявить отдельные фенотипы заболевания с разным риском прогрессирования и ответом на лечение.

IgA nephropathy (IgAN), first described in 1968, is the most common primary glomerulonephritis worldwide. The prevalence of the disease is highest in Asia compared with Europe and North America, with the possible underdiagnosis in regions such as Africa.

Typically, debuting in young patients, IgAN is one of the major causes of the development of end-stage chronic kidney disease, which requires the use of renal replacement therapy. However, recent studies have shown a rising incidence among older individuals, often with more severe outcomes.

The time course and prognosis of IgAN remain difficult to predict due to the pronounced polymorphism of clinical manifestations and morphological features, apparently reflecting a wide range of possible etiopathogenesis mechanisms. This literature review discusses current approaches to evaluating clinical symptoms and biomarkers in relation to pathomorphological features and disease prognosis. Traditionally, severe proteinuria has been regarded as the only reliable predictor of poor outcomes and the main indication for active treatment. However, recently evidence highlights the prognostic significance of proteinuria of any level, including persistent microhematuria, suggesting the need to reconsider current therapeutic paradigm. Two long-standing debates over the prognostic role of macrohematuria also remain unresolves. In addition, the review addresses the prognostic value of nephrotic syndrome depending on specific histological patterns, such as IgAN with minimal change disease or endocapillary proliferation. Based on published data, clinical variants of IgAN and their associations with disease outcomes are analyzed. The first results of cluster analysis, which have identified distinct disease phenotypes with differing risks of progression and treatment response, are also presented.

IgA нефропатиягломерулонефритпротеинуриягематуриянефротический синдромIgA nephropathyglomerulonephritisproteinuriahematurianephrotic syndromeReferencesBerger J, Hinglais N. [Intercapillary deposits of IgA-IgG]. J Urol Nephrol (Paris). 1968;74:694-695. (in French)Berger J, Hinglais N. [Intercapillary deposits of IgA-IgG]. J Urol Nephrol (Paris). 1968;74:694-695. (in French)Lai KN, Tang SC, Schena FP. et al. IgA Nephropathy. Nat Rev Dis Primers. 2016;2:16001. DOI: 10.1038/nrdp.2016.1Lai KN, Tang SC, Schena FP. et al. IgA Nephropathy. Nat Rev Dis Primers. 2016;2:16001. DOI: 10.1038/nrdp.2016.1Schena FP, Nistor I. Epidemiology of IgA Nephropathy: A Global Perspective. Semin Nephrol. 2018;38(5):435-442. DOI: 10.1016/j.semnephrol.2018.05.013Schena FP, Nistor I. Epidemiology of IgA Nephropathy: A Global Perspective. Semin Nephrol. 2018;38(5):435-442. DOI: 10.1016/j.semnephrol.2018.05.013Zhang Z, Zhang Y, Zhang H. IgA Nephropathy: A Chinese Perspective. Glomerular Dis. 2021;2(1):30-41. DOI: 10.1159/000520039Zhang Z, Zhang Y, Zhang H. IgA Nephropathy: A Chinese Perspective. Glomerular Dis. 2021;2(1):30-41. DOI: 10.1159/000520039Filippone EJ, Gulati R, Farber JL. Contemporary review of IgA nephropathy. Front Immunol. 2024;15:1436923. DOI: 10.3389/fimmu.2024.1436923Filippone EJ, Gulati R, Farber JL. Contemporary review of IgA nephropathy. Front Immunol. 2024;15:1436923. DOI: 10.3389/fimmu.2024.1436923Клинические рекомендаци: Гломерулярные болезни: иммуноглобулин А-нефропатия. 2024. 79 с.Guidelines: Glomerular diseases: immunoglobulin A nephropathy. 2024. 79s. (In Russian)Добронравов В.А., Мужецкая Т.О., Лин Д.И., Кочоян З.Ш. Иммуноглобулин А-нефропатия в российской популяции: клинико-морфологическая презентация и отдаленный прогноз. Нефрология 2019;23(6):45-60. DOI: 10.36485/1561-6274-2019-23-6-45-60 (In Russian)Dobronravov V.A., Muzhetskaya T.O., Lin D.I., Kochoyan Z.Sh. Immunoglobulin A-nephropathy in Russian population: clinical and morphological presentation and long-term prognosis. Nephrology (Saint-Petersburg) 2019;23(6):45-60. DOI: 10.36485/1561-6274-2019-23-6-45-60 (In Russian)Zhang H, Barratt J. Is IgA nephropathy the same disease in different parts of the world? Semin Immunopathol. 2021;43(5):707-715. DOI: 10.1007/s00281-021-00884-7Zhang H, Barratt J. Is IgA nephropathy the same disease in different parts of the world? Semin Immunopathol. 2021;43(5):707-715. DOI: 10.1007/s00281-021-00884-7Barbour SJ, Cattran DC, Kim SJ et al. Individuals of pacific asian origin with IgA nephropathy have an increased risk of progression to end-stage renal disease. Kidney Int. 2013; 84(5):1017-1024. DOI: 10.1038/ki.2013.210Barbour SJ, Cattran DC, Kim SJ et al. Individuals of pacific asian origin with IgA nephropathy have an increased risk of progression to end-stage renal disease. Kidney Int. 2013; 84(5):1017-1024. DOI: 10.1038/ki.2013.210Roberts ISD. Pathology of IgA nephropathy: A global perspective. Nephrology (Carlton). 2024;29(2):71-74. DOI: 10.1111/nep.14343Roberts ISD. Pathology of IgA nephropathy: A global perspective. Nephrology (Carlton). 2024;29(2):71-74. DOI: 10.1111/nep.14343Xu L, Zhou X, Zhang H. An update on the genetics of IgA nephropathy. J Clin Med. 2023;13(1):123. DOI: 10.3390/jcm13010123Xu L, Zhou X, Zhang H. An update on the genetics of IgA nephropathy. J Clin Med. 2023;13(1):123. DOI: 10.3390/jcm13010123Kiryluk K, Sanchez-Rodriguez E, Zhou X et al. Genome-wide association analyses define pathogenic signaling pathways and prioritize drug targets for IgA nephropathy. Nat Genet. 2023;55(7):1091-1105. DOI: 10.1038/s41588023-01422-xKiryluk K, Sanchez-Rodriguez E, Zhou X et al. Genome-wide association analyses define pathogenic signaling pathways and prioritize drug targets for IgA nephropathy. Nat Genet. 2023;55(7):1091-1105. DOI: 10.1038/s41588023-01422-xLi M, Yu X. Genetic determinants of IgA nephropathy: Eastern perspective. Semin Nephrol. 2018;38(5):455-460. DOI: 10.1016/j.semnephrol.2018.05.015Li M, Yu X. Genetic determinants of IgA nephropathy: Eastern perspective. Semin Nephrol. 2018;38(5):455-460. DOI: 10.1016/j.semnephrol.2018.05.015Sallustio F, Serino G, Cox SN et al. Aberrantly methylated DNA regions lead to low activation of CD4+ T-cells in IgA nephropathy. Clin Sci (Lond). 2016;130(9):733-746. DOI: 10.1042/CS20150711Sallustio F, Serino G, Cox SN et al. Aberrantly methylated DNA regions lead to low activation of CD4+ T-cells in IgA nephropathy. Clin Sci (Lond). 2016;130(9):733-746. DOI: 10.1042/CS20150711Serino G, Sallustio F, Cox SN et al. Abnormal miR-148b expression promotes aberrant glycosylation of IgA1 in IgA nephropathy. J Am Soc Nephrol. 2012;23(5):814-824. Doi: 10.1681/ASN.2011060567Serino G, Sallustio F, Cox SN et al. Abnormal miR-148b expression promotes aberrant glycosylation of IgA1 in IgA nephropathy. J Am Soc Nephrol. 2012;23(5):814-824. Doi: 10.1681/ASN.2011060567Yao X, Zhai Y, An H et al. MicroRNAs in igA nephropathy. Ren Fail. 2021;43(1):1298-1310. DOI: 10.1080/0886022X.2021.1977320Yao X, Zhai Y, An H et al. MicroRNAs in igA nephropathy. Ren Fail. 2021;43(1):1298-1310. DOI: 10.1080/0886022X.2021.1977320Knoop T, Vikse BE, Mwakimonga A et al. Long-term outcome in 145 patients with assumed benign immunoglobulin A nephropathy. Nephrol Dial Transplant. 2017;32(11):1841-1850. DOI: 10.1093/ndt/gfx242Knoop T, Vikse BE, Mwakimonga A et al. Long-term outcome in 145 patients with assumed benign immunoglobulin A nephropathy. Nephrol Dial Transplant. 2017;32(11):1841-1850. DOI: 10.1093/ndt/gfx242Gutierrez E, Zamora I, Ballarin JA et al. Long-term outcomes of IgA nephropathy presenting with minimal or no proteinuria. J Am Soc Nephrol. 2012;23(10):1753-1760. DOI: 10.1681/ASN.2012010063Gutierrez E, Zamora I, Ballarin JA et al. Long-term outcomes of IgA nephropathy presenting with minimal or no proteinuria. J Am Soc Nephrol. 2012;23(10):1753-1760. DOI: 10.1681/ASN.2012010063Faucon A-L, Lando S, Chrysostomou C et al. Primary glomerular diseases and long-term adverse health outcomes: A nationwide cohort study. J Intern Med. 2024;297(1):22-35. DOI: 10.1111/joim.20024Faucon A-L, Lando S, Chrysostomou C et al. Primary glomerular diseases and long-term adverse health outcomes: A nationwide cohort study. J Intern Med. 2024;297(1):22-35. DOI: 10.1111/joim.20024Moriyama T, Tanaka K, Iwasaki C et al. Prognosis in IgA nephropathy: 30-year analysis of 1,012 patients at a single center in Japan. PloS One. 2014;9(3):e91756. DOI: 10.1371/journal.pone.00917564Moriyama T, Tanaka K, Iwasaki C et al. Prognosis in IgA nephropathy: 30-year analysis of 1,012 patients at a single center in Japan. PloS One. 2014;9(3):e91756. DOI: 10.1371/journal.pone.00917564Shen X, Chen P, Liu M et al. Long-term outcomes of IgA nephropathy in China. Nephrol Dial Transplant. 2025;40(6):1137-1146. DOI: 10.1093/ndt/gfae252Shen X, Chen P, Liu M et al. Long-term outcomes of IgA nephropathy in China. Nephrol Dial Transplant. 2025;40(6):1137-1146. DOI: 10.1093/ndt/gfae252Pitcher D, Braddon F, Hendry B et al. Long-term outcomes in IgA nephropathy. Clin J Am Soc Nephrol. 2023;18(6):727-738. DOI: 10.2215/CJN.0000000000000135Pitcher D, Braddon F, Hendry B et al. Long-term outcomes in IgA nephropathy. Clin J Am Soc Nephrol. 2023;18(6):727-738. DOI: 10.2215/CJN.0000000000000135Barratt J, Lafayette RA, Rovin BH, Fellström B. Budesonide delayed-release capsules to reduce proteinuria in adults with primary immunoglobulin A nephropathy. Exp Rev Clin Immunol. 2023;19(7):699-710. DOI: 10.1080/1744666X.2023.2206119Barratt J, Lafayette RA, Rovin BH, Fellström B. Budesonide delayed-release capsules to reduce proteinuria in adults with primary immunoglobulin A nephropathy. Exp Rev Clin Immunol. 2023;19(7):699-710. DOI: 10.1080/1744666X.2023.2206119Trimarchi H, Haas M, Coppo R. Crescents and IgA Nephropathy: A Delicate Marriage. J Clin Med. 2022;11(13):3569. DOI: 10.3390/jcm11133569Trimarchi H, Haas M, Coppo R. Crescents and IgA Nephropathy: A Delicate Marriage. J Clin Med. 2022;11(13):3569. DOI: 10.3390/jcm11133569Sevillano AM, Diaz M, Caravaca-Fontan F et al., Barrios C. и др. IgA nephropathy in elderly patients. Spanish Group for the Study of Glomerular Diseases (GLOSEN). Clin J Am Soc Nephrol. 2019;14(8):1183-1192. DOI: 10.2215/CJNSevillano AM, Diaz M, Caravaca-Fontan F et al., Barrios C. и др. IgA nephropathy in elderly patients. Spanish Group for the Study of Glomerular Diseases (GLOSEN). Clin J Am Soc Nephrol. 2019;14(8):1183-1192. DOI: 10.2215/CJNWyatt RJ, Julian BA. IgA nephropathy. N Engl J Med. 2013;368(25):2402-2414. DOI: 10.1056/NEJMra1206793Wyatt RJ, Julian BA. IgA nephropathy. N Engl J Med. 2013;368(25):2402-2414. DOI: 10.1056/NEJMra1206793Li LS, Liu ZH. Epidemiologic data of renal diseases from a single unit in China: Analysis based on 13,519 renal biopsies. Kidney Int. 2004;66(3):920-923. DOI: 10.1111/j.1523-1755.2004.00837.xLi LS, Liu ZH. Epidemiologic data of renal diseases from a single unit in China: Analysis based on 13,519 renal biopsies. Kidney Int. 2004;66(3):920-923. DOI: 10.1111/j.1523-1755.2004.00837.xLe W, Liang S, Hu Y et al. Long-term renal survival and related risk factors in patients with IgA nephropathy: Results from a cohort of 1155 cases in a Chinese adult population. Nephrol. Dial. Transplant. 2012;27(4):1479-1485. DOI: 10.1093/ndt/gfr527Le W, Liang S, Hu Y et al. Long-term renal survival and related risk factors in patients with IgA nephropathy: Results from a cohort of 1155 cases in a Chinese adult population. Nephrol. Dial. Transplant. 2012;27(4):1479-1485. DOI: 10.1093/ndt/gfr527Weng M, Lin J, Chen Y et al. Time-Averaged Hematuria as a Prognostic Indicator of Renal Outcome in Patients with IgA Nephropathy. J Clin Med. 2022;11(22):6785. DOI: 10.3390/jcm11226785Weng M, Lin J, Chen Y et al. Time-Averaged Hematuria as a Prognostic Indicator of Renal Outcome in Patients with IgA Nephropathy. J Clin Med. 2022;11(22):6785. DOI: 10.3390/jcm11226785Park YH, Choi JY, Chung HS et al. Hematuria and proteinuria in a mass school urine screening test. Pediatr Nephrol. 2005;20(8):1126-1130. DOI: 10.1007/s00467-005-1915-8Park YH, Choi JY, Chung HS et al. Hematuria and proteinuria in a mass school urine screening test. Pediatr Nephrol. 2005;20(8):1126-1130. DOI: 10.1007/s00467-005-1915-8Honda M, Yanagihara T, Gotoh Y. School urinary screening program in Japan: history, outcomes, perspectives. Kidney Res Clin Pract. 2024;43(3):287-298. DOI:10.23876/j.krcp.23.127Honda M, Yanagihara T, Gotoh Y. School urinary screening program in Japan: history, outcomes, perspectives. Kidney Res Clin Pract. 2024;43(3):287-298. DOI:10.23876/j.krcp.23.127Han SH, Kang EW, Park JK et al. Spontaneous remission of nephrotic syndrome in patients with IgA nephropathy. Nephrol Dial Transplant. 2011;26(5):1570-1575. DOI: 10.1093/ndt/gfq559Han SH, Kang EW, Park JK et al. Spontaneous remission of nephrotic syndrome in patients with IgA nephropathy. Nephrol Dial Transplant. 2011;26(5):1570-1575. DOI: 10.1093/ndt/gfq559Kim J, Kim JH, Lee SC et al. Clinical features and outcomes of IgA nephropathy with nephrotic syndrome. Clin J Am Soc Nephrol. 2012;7(3):427-436. DOI: 10.2215/CJN.04820511Kim J, Kim JH, Lee SC et al. Clinical features and outcomes of IgA nephropathy with nephrotic syndrome. Clin J Am Soc Nephrol. 2012;7(3):427-436. DOI: 10.2215/CJN.04820511Herlitz LC, Bomback AC, Stokes MB et al. IgA Nephropathy with Minimal Change Disease. Clin J Am Soc Nephrol. 2014;10;9(6):1033-1039. DOI: 10.2215/CJN.11951113Herlitz LC, Bomback AC, Stokes MB et al. IgA Nephropathy with Minimal Change Disease. Clin J Am Soc Nephrol. 2014;10;9(6):1033-1039. DOI: 10.2215/CJN.11951113Wang TY, Chang FP, Yang AH et al. Key pathological features characterize minimal change disease-like IgA nephropathy. PLoS One. 2023;18(7):e0288384. DOI: 10.1371/journal.pone.0288384Wang TY, Chang FP, Yang AH et al. Key pathological features characterize minimal change disease-like IgA nephropathy. PLoS One. 2023;18(7):e0288384. DOI: 10.1371/journal.pone.0288384Qin J, Yang Q, Tang X et al. Clinicopathologic features and treatment response in nephrotic IgA nephropathy with minimal change disease. Clin Nephrol. 2013;79(1):37-44. DOI: 10.5414/CN107682Qin J, Yang Q, Tang X et al. Clinicopathologic features and treatment response in nephrotic IgA nephropathy with minimal change disease. Clin Nephrol. 2013;79(1):37-44. DOI: 10.5414/CN107682Cattran DC, Floege J, Coppo R. Evaluating progression risk in patients with immunoglobulin A nephropathy. Kidney Int Rep 2023;8(12):2515-2528. https://doi.org/10.1016/j.ekir.2023.09.020Cattran DC, Floege J, Coppo R. Evaluating progression risk in patients with immunoglobulin A nephropathy. Kidney Int Rep 2023;8(12):2515-2528. https://doi.org/10.1016/j.ekir.2023.09.020Goto M, Wakai K, Kawamura T et al. A scoring system to predict renal outcome in IgA nephropathy: A nationwide 10-year prospective cohort study. Nephrol Dial Transplant. 2009;24(10):3068-3074. DOI: 10.1093/ndt/gfp273Goto M, Wakai K, Kawamura T et al. A scoring system to predict renal outcome in IgA nephropathy: A nationwide 10-year prospective cohort study. Nephrol Dial Transplant. 2009;24(10):3068-3074. DOI: 10.1093/ndt/gfp273Berthoux F, Mohey H, Laurent B et al. Predicting the risk for dialysis or death in IgA nephropathy. J Am Soc Nephrol. 2011;22(4):752-761. DOI: 10.1681/ASN.2010040355Berthoux F, Mohey H, Laurent B et al. Predicting the risk for dialysis or death in IgA nephropathy. J Am Soc Nephrol. 2011;22(4):752-761. DOI: 10.1681/ASN.2010040355Cattran DC, Coppo R, Cook HT et al. Working Group of the International Ig ANN, the Renal Pathology Society. The Oxford classification of IgA nephropathy: rationale, clinicopathological correlations, and classification. Kidney Int. 2009;76(5):534-545. DOI: 10.1038/ki.2009.243Cattran DC, Coppo R, Cook HT et al. Working Group of the International Ig ANN, the Renal Pathology Society. The Oxford classification of IgA nephropathy: rationale, clinicopathological correlations, and classification. Kidney Int. 2009;76(5):534-545. DOI: 10.1038/ki.2009.243Trimarchi H, Barratt J, Cattran DC et al. Oxford classification of IgA nephropathy 2016: an update from the IgA nephropathy classification working group. Kidney Int. 2017;91(5):1014-1021. DOI: 10.1016/j.kint.2017.02.003Trimarchi H, Barratt J, Cattran DC et al. Oxford classification of IgA nephropathy 2016: an update from the IgA nephropathy classification working group. Kidney Int. 2017;91(5):1014-1021. DOI: 10.1016/j.kint.2017.02.003Bellur SS, Lepeytre F, Vorobyeva O et al. Evidence from the Oxford Classification cohort supports the clinical value of subclassification of focal segmental glomerulosclerosis in IgA nephropathy. Kidney Int. 2017;91(1):235-243. DOI: 10.1016/j.kint.2016.09.029Bellur SS, Lepeytre F, Vorobyeva O et al. Evidence from the Oxford Classification cohort supports the clinical value of subclassification of focal segmental glomerulosclerosis in IgA nephropathy. Kidney Int. 2017;91(1):235-243. DOI: 10.1016/j.kint.2016.09.029Howie AJ and Lalayiannis AD. Systematic Review of the Oxford Classification of IgA Nephropathy: Reproducibility and Prognostic Value. Kidney360. 2023;4(8):1103-1111. DOI: 10.34067/KID.0000000000000195Howie AJ and Lalayiannis AD. Systematic Review of the Oxford Classification of IgA Nephropathy: Reproducibility and Prognostic Value. Kidney360. 2023;4(8):1103-1111. DOI: 10.34067/KID.0000000000000195Herlitz LC. Reproducibility of Oxford Scoring in IgA Nephropathy: Is the Noise Due to an Educational Gap? Kidney360. 2023;4(8):1017-1018. DOI: 10.34067/KID.0000000000000234Herlitz LC. Reproducibility of Oxford Scoring in IgA Nephropathy: Is the Noise Due to an Educational Gap? Kidney360. 2023;4(8):1017-1018. DOI: 10.34067/KID.0000000000000234Lafayette RA, Reich HN, Stone AM, Barratt J. One-year estimated GFR slope independently predicts clinical benefit in immunoglobulin A nephropathy. Kidney Int Rep. 2022;7(12):2730-2733. DOI: 10.1016/j.ekir.2022.09.017Lafayette RA, Reich HN, Stone AM, Barratt J. One-year estimated GFR slope independently predicts clinical benefit in immunoglobulin A nephropathy. Kidney Int Rep. 2022;7(12):2730-2733. DOI: 10.1016/j.ekir.2022.09.017Barbour SJ, Cattran DC, Espino-Hernandez G et al. Identifying the ideal metric of proteinuria as a predictor of renal outcome in idiopathic glomerulonephritis. Kidney Int 2015;88:1392-1401. DOI: 10.1038/ki.2015.241Barbour SJ, Cattran DC, Espino-Hernandez G et al. Identifying the ideal metric of proteinuria as a predictor of renal outcome in idiopathic glomerulonephritis. Kidney Int 2015;88:1392-1401. DOI: 10.1038/ki.2015.241Reich HN, Troyanov S, Scholey JW, Cattran DC. Toronto Glomerulonephritis Registry. Remission of proteinuria improves prognosis in IgA nephropathy. J Am Soc Nephrol. 2007;18(12):3177-3183. DOI: 10.1681/ASN.2007050526Reich HN, Troyanov S, Scholey JW, Cattran DC. Toronto Glomerulonephritis Registry. Remission of proteinuria improves prognosis in IgA nephropathy. J Am Soc Nephrol. 2007;18(12):3177-3183. DOI: 10.1681/ASN.2007050526Inker LA, Mondal H, Greene T et al. Early change in urine protein as a surrogate end point in studies of IgA nephropathy: An individual-patient meta-analysis. Am J Kidney Dis. 2016;68(3):392-401. DOI: 10.1053/j.ajkd.2016.02.042Inker LA, Mondal H, Greene T et al. Early change in urine protein as a surrogate end point in studies of IgA nephropathy: An individual-patient meta-analysis. Am J Kidney Dis. 2016;68(3):392-401. DOI: 10.1053/j.ajkd.2016.02.042Thompson A, Carroll K, Inker L et al. Proteinuria reduction as a surrogate end point in trials of IgA nephropathy. Clin J Am Soc Nephrol. 2019;14(3):469-481. DOI: 10.2215/CJN.08600718Thompson A, Carroll K, Inker L et al. Proteinuria reduction as a surrogate end point in trials of IgA nephropathy. Clin J Am Soc Nephrol. 2019;14(3):469-481. DOI: 10.2215/CJN.08600718Rovin BH, Adler SG, Barratt J et al. (Kidney Disease: Improving Global Outcomes (KDIGO) Glomerular Diseases Work Group). KDIGO 2021 clinical practice guideline for the management of glomerular diseases. Kidney Int. 2021;100(4S):1-276. DOI: 10.1016/j.kint.2021.05.021Rovin BH, Adler SG, Barratt J et al. (Kidney Disease: Improving Global Outcomes (KDIGO) Glomerular Diseases Work Group). KDIGO 2021 clinical practice guideline for the management of glomerular diseases. Kidney Int. 2021;100(4S):1-276. DOI: 10.1016/j.kint.2021.05.021Tang C, Chen P, Si FL et al. Time-Varying Proteinuria and Progression of IgA Nephropathy: A Cohort Study. Am J Kidney Dis. 2024;84(2):170-178. DOI: 10.1053/j.ajkd.2023.12.016Tang C, Chen P, Si FL et al. Time-Varying Proteinuria and Progression of IgA Nephropathy: A Cohort Study. Am J Kidney Dis. 2024;84(2):170-178. DOI: 10.1053/j.ajkd.2023.12.016Huang N, Li J, Ai Z et al. Differences of clinicopathological characteristics and outcomes of IgA nephropathy patients with and without nephrotic syndrome. Int Urol Nephrol. 2024;56(9):3003-3011. DOI: 10.1007/s11255-024-04040-6Huang N, Li J, Ai Z et al. Differences of clinicopathological characteristics and outcomes of IgA nephropathy patients with and without nephrotic syndrome. Int Urol Nephrol. 2024;56(9):3003-3011. DOI: 10.1007/s11255-024-04040-6Li H, Wang F, Jia J et al. The difference between patients with nephrotic syndrome and nephrotic-range proteinuria in IgA nephropathy: A propensity score matched cohort study. BMC Nephrol. 2022;23(1):163. DOI: 10.1186/s12882-022-02799-3Li H, Wang F, Jia J et al. The difference between patients with nephrotic syndrome and nephrotic-range proteinuria in IgA nephropathy: A propensity score matched cohort study. BMC Nephrol. 2022;23(1):163. DOI: 10.1186/s12882-022-02799-3Jiang Y, Chen P, Zhao W et al. Distinct characteristics and prognosis of IgA nephropathy patients with nephrotic syndrome: A propensity score-matched cohort study. Front Med (Lausanne). 2024;11:1344219. DOI: 10.3389/fmed.2024.1344219Jiang Y, Chen P, Zhao W et al. Distinct characteristics and prognosis of IgA nephropathy patients with nephrotic syndrome: A propensity score-matched cohort study. Front Med (Lausanne). 2024;11:1344219. DOI: 10.3389/fmed.2024.1344219Schena FP. Survey of the Italian Registry of Renal Biopsies. Frequency of the renal diseases for 7 consecutive years. The Italian Group of Renal Immunopathology. Nephrol Dial Transplant 1997;12(3):418-426. DOI: 10.1093/ndt/12.3.418Schena FP. Survey of the Italian Registry of Renal Biopsies. Frequency of the renal diseases for 7 consecutive years. The Italian Group of Renal Immunopathology. Nephrol Dial Transplant 1997;12(3):418-426. DOI: 10.1093/ndt/12.3.418Zand L, Fervenza FC, Coppo R. Microscopic hematuria as a risk factor for IgAN progression: considering this biomarker in selecting and monitoring patients. Clin Kidney J. 2023;16(2):ii19-ii27. DOI: 10.1093/ckj/sfad232Zand L, Fervenza FC, Coppo R. Microscopic hematuria as a risk factor for IgAN progression: considering this biomarker in selecting and monitoring patients. Clin Kidney J. 2023;16(2):ii19-ii27. DOI: 10.1093/ckj/sfad232Coppo R., Fervenza F.C. Persistent Microscopic Hematuria as a Risk Factor for Progression of IgA Nephropathy: New Floodlight on a Nearly Forgotten Biomarker. J Am Soc Nephrol. 2017;28(10):2831-2834. DOI: 10.1681/ASN.2017060639Coppo R., Fervenza F.C. Persistent Microscopic Hematuria as a Risk Factor for Progression of IgA Nephropathy: New Floodlight on a Nearly Forgotten Biomarker. J Am Soc Nephrol. 2017;28(10):2831-2834. DOI: 10.1681/ASN.2017060639D'Amico G, Ferrario F, Colasanti G et al. IgA-mesangial nephropathy (Berger's disease) with rapid decline in renal function. Clin Nephrol 1981;16(5):251-257D'Amico G, Ferrario F, Colasanti G et al. IgA-mesangial nephropathy (Berger's disease) with rapid decline in renal function. Clin Nephrol 1981;16(5):251-257Bennett WM, Kincaid-Smith P. Macroscopic hematuria in mesangial IgA nephropathy: correlation with glomerular crescents and renal dysfunction. Kidney Int. 1983;23(2):393-400. DOI: 10.1038/ki.1983.32Bennett WM, Kincaid-Smith P. Macroscopic hematuria in mesangial IgA nephropathy: correlation with glomerular crescents and renal dysfunction. Kidney Int. 1983;23(2):393-400. DOI: 10.1038/ki.1983.32Ibels LS, Györy AZ. IgA nephropathy: analysis of the natural history, important factors in the progression of renal disease, and a review of the literature. Medicine (Baltimore). 1994;73(2):79-102Ibels LS, Györy AZ. IgA nephropathy: analysis of the natural history, important factors in the progression of renal disease, and a review of the literature. Medicine (Baltimore). 1994;73(2):79-102Tanaka K, Moriyama T, Iwasaki C et al. Effect of hematuria on the outcome of IgA nephropathy with mild proteinuria. Clin. Exp. Nephrol. 2015;19(5):815-821. DOI: 10.1007/s10157-014-1068-9Tanaka K, Moriyama T, Iwasaki C et al. Effect of hematuria on the outcome of IgA nephropathy with mild proteinuria. Clin. Exp. Nephrol. 2015;19(5):815-821. DOI: 10.1007/s10157-014-1068-9Iwasaki C, Moriyama T, Tanaka K et al. Effect of hematuria on the outcome of immunoglobulin A nephropathy with proteinuria. J Nephropathol 2016;5(2):72-78. DOI: 10.15171/jnp.2016.12Iwasaki C, Moriyama T, Tanaka K et al. Effect of hematuria on the outcome of immunoglobulin A nephropathy with proteinuria. J Nephropathol 2016;5(2):72-78. DOI: 10.15171/jnp.2016.12Vivante A, Calderon-Margalit R, Skorecki K. Hematuria and risk for end-stage kidney disease. Curr Opin Nephrol Hypertens. 2013;22(3):325-330. DOI: 10.1097/MNH.0b013e32835f7241Vivante A, Calderon-Margalit R, Skorecki K. Hematuria and risk for end-stage kidney disease. Curr Opin Nephrol Hypertens. 2013;22(3):325-330. DOI: 10.1097/MNH.0b013e32835f7241Yu GZ, Guo L, Dong JF et al. Persistent Hematuria and Kidney Disease Progression in IgA Nephropathy: A Cohort Study. Am J Kidney Dis. 2020;76(1):90-99. DOI: 10.1053/j.ajkd.2019.11.008Yu GZ, Guo L, Dong JF et al. Persistent Hematuria and Kidney Disease Progression in IgA Nephropathy: A Cohort Study. Am J Kidney Dis. 2020;76(1):90-99. DOI: 10.1053/j.ajkd.2019.11.008He P, Wang H, Huang C, He L. Hematuria was a high risk for renal progression and ESRD in immunoglobulin А nephropathy: A systematic review and meta-analysis. Ren Fail. 2021;43(1):488-499. DOI: 10.1080/0886022X.2021.1879852He P, Wang H, Huang C, He L. Hematuria was a high risk for renal progression and ESRD in immunoglobulin А nephropathy: A systematic review and meta-analysis. Ren Fail. 2021;43(1):488-499. DOI: 10.1080/0886022X.2021.1879852Huang Z, Zhang J, Chen B et al. Clinical Significance of Persistent Hematuria Degrees in Primary IgA Nephropathy: A Propensity Score-Matched Analysis of a 10-Year Follow-Up Cohort. Am J Nephrol. 2023;54(1-2):62-73. DOI: 10.1159/000529650Huang Z, Zhang J, Chen B et al. Clinical Significance of Persistent Hematuria Degrees in Primary IgA Nephropathy: A Propensity Score-Matched Analysis of a 10-Year Follow-Up Cohort. Am J Nephrol. 2023;54(1-2):62-73. DOI: 10.1159/000529650Bobart SA, Alexander MP, Shawwa K et al. The association of microhematuria with mesangial hypercellularity, endocapillary hypercellularity, crescent score and renal outcomes in immunoglobulin A nephropathy. Nephrol Dial Transplant, 2021;36(5):840-847. DOI: 10.1093/ndt/gfz267Bobart SA, Alexander MP, Shawwa K et al. The association of microhematuria with mesangial hypercellularity, endocapillary hypercellularity, crescent score and renal outcomes in immunoglobulin A nephropathy. Nephrol Dial Transplant, 2021;36(5):840-847. DOI: 10.1093/ndt/gfz267Nagai M, Kobayashi N, Izumi N et al. Pre-treatment hematuria and crescents predict estimated glomerular filtration rate trajectory after methylprednisolone pulse therapy with tonsillectomy for IgA nephropathy. J Nephrol. 2022;35(2):441-449. DOI: 10.1007/s40620-021-01064-4Nagai M, Kobayashi N, Izumi N et al. Pre-treatment hematuria and crescents predict estimated glomerular filtration rate trajectory after methylprednisolone pulse therapy with tonsillectomy for IgA nephropathy. J Nephrol. 2022;35(2):441-449. DOI: 10.1007/s40620-021-01064-4Sevillano AM, Gutierrez JAM, Yuste C et al. Remission of Hematuria Improves Renal Survival in IgA Nephropathy. J Am Soc Nephrol. 2017;28(10):3089-3099. DOI: 10.1681/ASN.2017010108Sevillano AM, Gutierrez JAM, Yuste C et al. Remission of Hematuria Improves Renal Survival in IgA Nephropathy. J Am Soc Nephrol. 2017;28(10):3089-3099. DOI: 10.1681/ASN.2017010108Floege J, Bernier-Jean A, Barratt J, Rovin B. Treatment of patients with IgA nephropathy: a call for a new paradigm. Kidney Int. 2025;107(4):640-651. DOI: 10.1016/j.kint.2025.01.014Floege J, Bernier-Jean A, Barratt J, Rovin B. Treatment of patients with IgA nephropathy: a call for a new paradigm. Kidney Int. 2025;107(4):640-651. DOI: 10.1016/j.kint.2025.01.014Praga M, Caravaca-Fontan F, Da Silva I et al. Tailored management strategies for IgA nephropathy based on clinical presentations. Nephrol Dial Transplant. 2025;40(5):874-883 DOI: 10.1093/ndt/gfae289Praga M, Caravaca-Fontan F, Da Silva I et al. Tailored management strategies for IgA nephropathy based on clinical presentations. Nephrol Dial Transplant. 2025;40(5):874-883 DOI: 10.1093/ndt/gfae289D’Amico G. Natural history of idiopathic IgA nephropathy and factors predictive of disease outcome. Semin. Nephrol. 2004;24(3):179-196. DOI: 10.1016/j.semnephrol.2004.01.001D’Amico G. Natural history of idiopathic IgA nephropathy and factors predictive of disease outcome. Semin. Nephrol. 2004;24(3):179-196. DOI: 10.1016/j.semnephrol.2004.01.001Beukhof JR, Kardaun O, Schaafsma W et al. Toward individual prognosis of IgA nephropathy. Kidney Int. 1986;29(2):549-556. DOI: 10.1038/ki.1986.33Beukhof JR, Kardaun O, Schaafsma W et al. Toward individual prognosis of IgA nephropathy. Kidney Int. 1986;29(2):549-556. DOI: 10.1038/ki.1986.33Le W, Liang S, Chen H et al. Long-term outcome of IgA nephropathy patients with recurrent macroscopic hematuria. Am J Nephrol. 2014;40(1):43-50. DOI: 10.1159/000364954Le W, Liang S, Chen H et al. Long-term outcome of IgA nephropathy patients with recurrent macroscopic hematuria. Am J Nephrol. 2014;40(1):43-50. DOI: 10.1159/000364954Praga M, Gutierrez-Millet V, Navas JJ et al. Acute worsening of renal function during episodes of macroscopic hematuria in IgA nephropathy. Kidney Int 1985;28(1):69-74. DOI: 10.1038/ki.1985.120Praga M, Gutierrez-Millet V, Navas JJ et al. Acute worsening of renal function during episodes of macroscopic hematuria in IgA nephropathy. Kidney Int 1985;28(1):69-74. DOI: 10.1038/ki.1985.120Moreno JA, Martin-Cleary C, Gutierrez E et al. AKI Associated with Macroscopic Glomerular Hematuria: Clinical and Pathophysiologic Consequences. Clin J Am Soc Nephrol. 2012;7(1):175-184. DOI: 10.2215/CJN.01970211Moreno JA, Martin-Cleary C, Gutierrez E et al. AKI Associated with Macroscopic Glomerular Hematuria: Clinical and Pathophysiologic Consequences. Clin J Am Soc Nephrol. 2012;7(1):175-184. DOI: 10.2215/CJN.01970211Gutierrez E, Gonzalez E, Hernandez E et al. Factors that determine an incomplete recovery of renal function in macrohematuria-induced acute renal failure of IgA nephropathy. Clin J Am Soc Nephrol. 2007;2(1):51-57. DOI: 10.2215/CJN.02670706Gutierrez E, Gonzalez E, Hernandez E et al. Factors that determine an incomplete recovery of renal function in macrohematuria-induced acute renal failure of IgA nephropathy. Clin J Am Soc Nephrol. 2007;2(1):51-57. DOI: 10.2215/CJN.02670706Wang Y, Wen Q, Lian X et al. Machine learning-based unsupervised phenotypic clustering analysis of patients with IgA nephropathy: Distinct therapeutic responses of different groups. Chin Med J (Engl). 2025; Online ahead of print. DOI: 10.1097/CM9.0000000000003422Wang Y, Wen Q, Lian X et al. Machine learning-based unsupervised phenotypic clustering analysis of patients with IgA nephropathy: Distinct therapeutic responses of different groups. Chin Med J (Engl). 2025; Online ahead of print. DOI: 10.1097/CM9.0000000000003422Barbour SJ, Espino-Hernandez G, Reich HN et al. The MEST score provides earlier risk prediction in lgA nephropathy. Kidney Int. 2016;89(1):167-175. DOI: 10.1038/ki.2015.322Barbour SJ, Espino-Hernandez G, Reich HN et al. The MEST score provides earlier risk prediction in lgA nephropathy. Kidney Int. 2016;89(1):167-175. DOI: 10.1038/ki.2015.322Chen H, Liu Y, Wei L et al. The effect of fibrinoid necrosis on the clinical features and outcomes of primary IgA nephropathy. BMC Nephrol. 2023;24(1):366. DOI: 10.1186/s12882-023-03419-4Chen H, Liu Y, Wei L et al. The effect of fibrinoid necrosis on the clinical features and outcomes of primary IgA nephropathy. BMC Nephrol. 2023;24(1):366. DOI: 10.1186/s12882-023-03419-4Lee J, Jang S, Cho N et al. Severity of foot process effacement is associated with proteinuria in patients with IgA nephropathy. Kidney Res Clin Pract. 2020;39(3):295-304. DOI: 10.23876/j.krcp.20.017Lee J, Jang S, Cho N et al. Severity of foot process effacement is associated with proteinuria in patients with IgA nephropathy. Kidney Res Clin Pract. 2020;39(3):295-304. DOI: 10.23876/j.krcp.20.017Hara M, Yanagihara T, Kihara I. Cumulative excretion of urinary podocytes reflects disease progression in IgA nephropathy and schönlein-henoch purpura nephritis. Clin J Am Soc Nephrol. 2007;2(2):231-238. DOI: 10.2215/CJN.01470506Hara M, Yanagihara T, Kihara I. Cumulative excretion of urinary podocytes reflects disease progression in IgA nephropathy and schönlein-henoch purpura nephritis. Clin J Am Soc Nephrol. 2007;2(2):231-238. DOI: 10.2215/CJN.01470506Working Group of the International IgA Nephropathy Network and the Renal Pathology Society; Cattran DC, Coppo R, Cook HT et al. The oxford classification of IgA nephropathy: Rationale, clinicopathological correlations, and classification. Kidney Int. 2009;76(5):534-545. DOI: 10.1038/ki.2009.243Working Group of the International IgA Nephropathy Network and the Renal Pathology Society; Cattran DC, Coppo R, Cook HT et al. The oxford classification of IgA nephropathy: Rationale, clinicopathological correlations, and classification. Kidney Int. 2009;76(5):534-545. DOI: 10.1038/ki.2009.243Coppo R, Troyanov S, Bellur S et al. Validation of the oxford classification of IgA nephropathy in cohorts with different presentations and treatments. Kidney Int. 2014;86(4):828-836. DOI: 10.1038/ki.2014.63Coppo R, Troyanov S, Bellur S et al. Validation of the oxford classification of IgA nephropathy in cohorts with different presentations and treatments. Kidney Int. 2014;86(4):828-836. DOI: 10.1038/ki.2014.63Chang A, Kowalewska J, Smith KD et al. A clinicopathologic study of thrombotic microangiopathy in the setting of IgA nephropathy. Clin Nephrol. 2006;66(6):397-404. DOI: 10.5414/CNP66397Chang A, Kowalewska J, Smith KD et al. A clinicopathologic study of thrombotic microangiopathy in the setting of IgA nephropathy. Clin Nephrol. 2006;66(6):397-404. DOI: 10.5414/CNP66397El Karoui K, Hill GS, Karras A et al. A clinicopathologic study of thrombotic microangiopathy in IgA nephropathy. J Am Soc Nephrol. 2012;23(1):137-148. DOI: 10.1681/ASN.2010111130El Karoui K, Hill GS, Karras A et al. A clinicopathologic study of thrombotic microangiopathy in IgA nephropathy. J Am Soc Nephrol. 2012;23(1):137-148. DOI: 10.1681/ASN.2010111130Asrar I, Hussain M, Afzal A et al. Blind Spot in the Radar of MEST-C Score: Type and Severity of Tubulointerstitial Nephritis in IgA Nephropathy. Int J Nephrol. 2023;2023:1060526. DOI: 10.1155/2023/1060526.Asrar I, Hussain M, Afzal A et al. Blind Spot in the Radar of MEST-C Score: Type and Severity of Tubulointerstitial Nephritis in IgA Nephropathy. Int J Nephrol. 2023;2023:1060526. DOI: 10.1155/2023/1060526.Rankin AJ, Kipgen D, Geddes CC et al. Assessment of active tubulointerstitial nephritis in non-scarred renal cortex improves prediction of renal outcomes in patients with IgA nephropathy. Clin Kidney J. 2018;12(3):348-354. DOI: 10.1093/ckj/sfy093.Rankin AJ, Kipgen D, Geddes CC et al. Assessment of active tubulointerstitial nephritis in non-scarred renal cortex improves prediction of renal outcomes in patients with IgA nephropathy. Clin Kidney J. 2018;12(3):348-354. DOI: 10.1093/ckj/sfy093.Sun Q, Zhang Z, Zhang H, Liu X. Aberrant IgA1 glycosylation in IgA nephropathy: A systematic review. PloS One. 2016;11(11):e0166700. DOI: 10.1371/journal.pone.0166700Sun Q, Zhang Z, Zhang H, Liu X. Aberrant IgA1 glycosylation in IgA nephropathy: A systematic review. PloS One. 2016;11(11):e0166700. DOI: 10.1371/journal.pone.0166700Moldoveanu Z, Suzuki H, Reily C et al. Experimental evidence of pathogenic role of IgG autoantibodies in IgA nephropathy. J Autoimmun. 2021;118:102593. DOI: 10.1016/j.jaut.2021.102593Moldoveanu Z, Suzuki H, Reily C et al. Experimental evidence of pathogenic role of IgG autoantibodies in IgA nephropathy. J Autoimmun. 2021;118:102593. DOI: 10.1016/j.jaut.2021.102593Berthoux F, Suzuki H, Thibaudin L et al. Autoantibodies targeting galactose-deficient IgA1 associate with progression of IgA nephropathy. J Am Soc Nephrol. 2012; 23(9) 1579-1587. DOI: 10.1681/ASN.2012010053Berthoux F, Suzuki H, Thibaudin L et al. Autoantibodies targeting galactose-deficient IgA1 associate with progression of IgA nephropathy. J Am Soc Nephrol. 2012; 23(9) 1579-1587. DOI: 10.1681/ASN.2012010053Zhao N, Hou P, Lv J et al. The level of galactose-deficient IgA1 in the sera of patients with IgA nephropathy is associated with disease progression. Kidney Int. 2012;82(7):790-796. DOI:10.1038/ki.2012.197Zhao N, Hou P, Lv J et al. The level of galactose-deficient IgA1 in the sera of patients with IgA nephropathy is associated with disease progression. Kidney Int. 2012;82(7):790-796. DOI:10.1038/ki.2012.197Maixnerova D, Ling C, Hall S et al. Galactose-deficient IgA1 and the corresponding IgG autoantibodies predict IgA nephropathy progression. PLoS ONE. 2019;14(2):e0212254. DOI: 10.1371/journal.pone.0212254Maixnerova D, Ling C, Hall S et al. Galactose-deficient IgA1 and the corresponding IgG autoantibodies predict IgA nephropathy progression. PLoS ONE. 2019;14(2):e0212254. DOI: 10.1371/journal.pone.0212254Berthelot L, Robert T, Vuiblet V et al. Recurrent IgA nephropathy is predicted by altered glycosylated IgA, autoantibodies and soluble CD89 complexes. Kidney Int. 2015;88(4):815-822. DOI: 10.1038/ki.2015.158Berthelot L, Robert T, Vuiblet V et al. Recurrent IgA nephropathy is predicted by altered glycosylated IgA, autoantibodies and soluble CD89 complexes. Kidney Int. 2015;88(4):815-822. DOI: 10.1038/ki.2015.158Oortwijn BD, Eijgenraam J, Rastaldi M et al. The role of secretory IgA and complement in IgA nephropathy. Semin Nephrol. 2008;28(1):58-65. DOI: 10.1016/j.semnephrol.2007.10.007Oortwijn BD, Eijgenraam J, Rastaldi M et al. The role of secretory IgA and complement in IgA nephropathy. Semin Nephrol. 2008;28(1):58-65. DOI: 10.1016/j.semnephrol.2007.10.007Liang Y, Zhang J, Zhou Y et al. Proliferation and cytokine production of human mesangial cells stimulated by secretory IgA isolated from patients with IgA nephropathy. Cell Physiol Biochem. 2015;36(5):1793-1808. DOI: 10.1159/000430151Liang Y, Zhang J, Zhou Y et al. Proliferation and cytokine production of human mesangial cells stimulated by secretory IgA isolated from patients with IgA nephropathy. Cell Physiol Biochem. 2015;36(5):1793-1808. DOI: 10.1159/000430151TominoY, Suzuki S, Imai H et al. Measurement of serum IgA and C3 may predict the diagnosis of patients with IgA nephropathy prior to renal biopsy. J Clin Lab Anal. 2000;14(5):220-223. DOI: 10.1002/10982825(2000)14:5TominoY, Suzuki S, Imai H et al. Measurement of serum IgA and C3 may predict the diagnosis of patients with IgA nephropathy prior to renal biopsy. J Clin Lab Anal. 2000;14(5):220-223. DOI: 10.1002/10982825(2000)14:5Mizerska-Wasiak M, Małdyk J, Rybi-Szuminska A et al. Relationship between serum IgA/C3 ratio and severity of histological lesions using the oxford classification in children with IgA nephropathy. Pediatr Nephrol. 2015;30(7):1113-1120. DOI: 10.1007/s00467-014-3024-zMizerska-Wasiak M, Małdyk J, Rybi-Szuminska A et al. Relationship between serum IgA/C3 ratio and severity of histological lesions using the oxford classification in children with IgA nephropathy. Pediatr Nephrol. 2015;30(7):1113-1120. DOI: 10.1007/s00467-014-3024-zChen P, Yu G, Zhang X et al. Plasma galactose-deficient IgA1 and C3 and CKD progression in IgA nephropathy. Clin J Am Soc Nephrol. 2019;14(10):1458-1465. DOI: 10.2215/CJN.13711118Chen P, Yu G, Zhang X et al. Plasma galactose-deficient IgA1 and C3 and CKD progression in IgA nephropathy. Clin J Am Soc Nephrol. 2019;14(10):1458-1465. DOI: 10.2215/CJN.13711118Maeda A, Gohda T, Funabiki K et al. Significance of serum IgA levels and serum IgA/C3 ratio in diagnostic analysis of patients with IgA nephropathy. 2003;17(3):73-76. DOI: 10.1002/jcla.10071Maeda A, Gohda T, Funabiki K et al. Significance of serum IgA levels and serum IgA/C3 ratio in diagnostic analysis of patients with IgA nephropathy. 2003;17(3):73-76. DOI: 10.1002/jcla.10071Kawasaki Y, Maeda R, Ohara S et al. Serum IgA/C3 and glomerular C3 staining predict severity of IgA nephropathy. Pediatr Int. 2018;60(2):162-167. DOI: 10.1111/ped.13461Kawasaki Y, Maeda R, Ohara S et al. Serum IgA/C3 and glomerular C3 staining predict severity of IgA nephropathy. Pediatr Int. 2018;60(2):162-167. DOI: 10.1111/ped.13461Hou J, Fu S, Wang X et al. A noninvasive artificial neural network model to predict IgA nephropathy risk in Chinese population. Sci Rep. 2022;12(1):8296. DOI: 10.1038/s41598-022-11964-5Hou J, Fu S, Wang X et al. A noninvasive artificial neural network model to predict IgA nephropathy risk in Chinese population. Sci Rep. 2022;12(1):8296. DOI: 10.1038/s41598-022-11964-5Xu Z, Zhan H, Zhan J et al. New biomarkers in IgA nephropathy. Clin Immunol. 2025;274:110468. DOI: 10.1016/j.clim.2025.110468Xu Z, Zhan H, Zhan J et al. New biomarkers in IgA nephropathy. Clin Immunol. 2025;274:110468. DOI: 10.1016/j.clim.2025.110468Zhang Y, Duan SW, Chen P et al. Relationship between serum C3/C4 ratio and prognosis of immunoglobulin A nephropathy based on propensity score matching. Chin Med J (Engl). 2020;133(6):631-637. DOI: 10.1097/CM9.0000000000000674Zhang Y, Duan SW, Chen P et al. Relationship between serum C3/C4 ratio and prognosis of immunoglobulin A nephropathy based on propensity score matching. Chin Med J (Engl). 2020;133(6):631-637. DOI: 10.1097/CM9.0000000000000674Wu D, Li X, Yao X et al. Mesangial C3 deposition and serum C3 levels predict renal outcome in IgA nephropathy. Clin Exp Nephrol. 2021;25:641-651. DOI: 10.1007/s10157-021-02034-7Wu D, Li X, Yao X et al. Mesangial C3 deposition and serum C3 levels predict renal outcome in IgA nephropathy. Clin Exp Nephrol. 2021;25:641-651. DOI: 10.1007/s10157-021-02034-7Medjeral-Thomas NR, Lomax-Browne HJ, Beckwith H et al. Circulating complement factor H–related proteins 1 and 5 correlate with disease activity in IgA nephropathy. Kidney Int. 2017;92(4):942-952. DOI: 10.1016/j.kint.2017.03.043.Medjeral-Thomas NR, Lomax-Browne HJ, Beckwith H et al. Circulating complement factor H–related proteins 1 and 5 correlate with disease activity in IgA nephropathy. Kidney Int. 2017;92(4):942-952. DOI: 10.1016/j.kint.2017.03.043.Roos A, Rastaldi MP, Calvaresi N et al. Glomerular activation of the lectin pathway of complement in IgA nephropathy is associated with more severe renal disease. J Am Soc Nephrol. 2006;17(6):1724-1734. DOI: 10.1681/ASN.2005090923Roos A, Rastaldi MP, Calvaresi N et al. Glomerular activation of the lectin pathway of complement in IgA nephropathy is associated with more severe renal disease. J Am Soc Nephrol. 2006;17(6):1724-1734. DOI: 10.1681/ASN.2005090923Faria B, Canao P, Cai Q et al. Arteriolar C4d in IgA nephropathy: A cohort study. Am J Kidney Dis. 2020;76(5):669-678. DOI: 10.1053/j.ajkd.2020.03.017Faria B, Canao P, Cai Q et al. Arteriolar C4d in IgA nephropathy: A cohort study. Am J Kidney Dis. 2020;76(5):669-678. DOI: 10.1053/j.ajkd.2020.03.017Espinosa M, Ortega R, Sanchez M et al.; Spanish Group for Study of Glomerular Diseases (GLOSEN): Association of C4d deposition with clinical outcomes in IgA nephropathy. Clin J Am Soc Nephrol. 2014;9(5):897-904. DOI: 10.2215/CJN.09710913Espinosa M, Ortega R, Sanchez M et al.; Spanish Group for Study of Glomerular Diseases (GLOSEN): Association of C4d deposition with clinical outcomes in IgA nephropathy. Clin J Am Soc Nephrol. 2014;9(5):897-904. DOI: 10.2215/CJN.09710913Oortwijn BD, Rastaldi MP, Roos A et al. Demonstration of secretory IgA in kidneys of patients with IgA nephropathy. Nephrol Dial Transplant. 2007;22(11):3191-3195. DOI: 10.1093/ndt/gfm346Oortwijn BD, Rastaldi MP, Roos A et al. Demonstration of secretory IgA in kidneys of patients with IgA nephropathy. Nephrol Dial Transplant. 2007;22(11):3191-3195. DOI: 10.1093/ndt/gfm346Zhang J, Xu L, Liu G et al. The level of serum secretory IgA of patients with IgA nephropathy is elevated and associated with pathological phenotypes. Nephrol Dial Transplant. 2008;23(1):207-212. DOI: 10.1093/ndt/gfm492Zhang J, Xu L, Liu G et al. The level of serum secretory IgA of patients with IgA nephropathy is elevated and associated with pathological phenotypes. Nephrol Dial Transplant. 2008;23(1):207-212. DOI: 10.1093/ndt/gfm492Kouri NM, Stangou M, Lioulios G et al. Serum levels of miR-148b and let-7b at diagnosis may have important impact in the response to treatment and long-term outcome in IgA nephropathy. J Clin Med. 2021;10 (9):1987. DOI: 10.3390/jcm10091987Kouri NM, Stangou M, Lioulios G et al. Serum levels of miR-148b and let-7b at diagnosis may have important impact in the response to treatment and long-term outcome in IgA nephropathy. J Clin Med. 2021;10 (9):1987. DOI: 10.3390/jcm10091987Serino G, Pesce F, Sallustio F et al. In a retrospective international study, circulating miR-148b and let-7b were found to be serum markers for detecting primary IgA nephropathy. Kidney Int. 2016;89(3):683-692. DOI: 10.1038/ki.2015.333Serino G, Pesce F, Sallustio F et al. In a retrospective international study, circulating miR-148b and let-7b were found to be serum markers for detecting primary IgA nephropathy. Kidney Int. 2016;89(3):683-692. DOI: 10.1038/ki.2015.333Wang G, Kwan BC, Lai FM et al. Intrarenal expression of microRNAs in patients with IgA nephropathy. Lab Invest. 2010;90(1):98-103. DOI: 10.1038/labinvest.2009.118Wang G, Kwan BC, Lai FM et al. Intrarenal expression of microRNAs in patients with IgA nephropathy. Lab Invest. 2010;90(1):98-103. DOI: 10.1038/labinvest.2009.118Barbour SJ, Coppo R, Zhang H et al. Evaluating a new international risk-prediction tool in IgA nephropathy. JAMA Intern Med. 2019;179:942-952. DOI: 10.1001/jamainternmed.2019.0600Barbour SJ, Coppo R, Zhang H et al. Evaluating a new international risk-prediction tool in IgA nephropathy. JAMA Intern Med. 2019;179:942-952. DOI: 10.1001/jamainternmed.2019.0600Barbour SJ, Coppo R, Zhang H et al. Application of the International IgA Nephropathy Prediction Tool one or two years post-biopsy. Kidney Int. 2022;102(1):160-172. DOI: 10.1016/j.kint.2022.02.042Barbour SJ, Coppo R, Zhang H et al. Application of the International IgA Nephropathy Prediction Tool one or two years post-biopsy. Kidney Int. 2022;102(1):160-172. DOI: 10.1016/j.kint.2022.02.042

The authors declare that there are no conflicts of interest present.