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The Emirates Medical Association of Nephrology and Transplantation Society Consensus Statements on Optimizing Clinical Management of IgA Nephropathy: The Urgent Need for a Paradigm Shift in the UAE

DOI: 10.4236/ijcm.2026.176014, PP. 181-200

Keywords: Immunoglobulin A Nephropathy, IgAN, UAE, Management, Consensus

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Abstract:

Immunoglobulin A nephropathy (IgAN) is the most common form of primary glomerular disease worldwide. IgAN leads to end stage kidney disease in up to 40% - 50% of all patients and is associated with increased mortality, leading to a clear need for increased awareness and early treatment of the disease. In the United Arab Emirates (UAE), the number of IgAN diagnoses has steadily risen over several decades, putting increased pressure on primary care physicians and nephrologists to find nationwide solutions to optimize its clinical management. In recognition of this growing need, the Emirates Medical Association Nephrology and Transplantation Society (EMAN-T) convened a panel of 12 experts with recognized seniority in IgAN clinical management, who identified challenges and opportunities for improving and standardizing national IgAN care pathways. A limitation was a lack of patient or payer representation on the consensus panel. This expert clinical consensus article provides 6 consensus position statements that together set out a vision for optimal IgAN clinical management in the UAE. The statements are intended to serve as a first step towards optimizing IgAN awareness, diagnosis, risk assessment, treatment and ongoing clinical management, with the ultimate goal of improving care pathways for IgAN across the UAE.

References

[1]  Pitcher, D., Braddon, F., Hendry, B., Mercer, A., Osmaston, K., Saleem, M.A., et al. (2023) Long-Term Outcomes in IgA Nephropathy. Clinical Journal of the American Society of Nephrology, 18, 727-738.
https://doi.org/10.2215/cjn.0000000000000135
[2]  Rout, P. and Afzal, M. (2025) IgA Nephropathy (Berger Disease). StatPearls Publishing.
[3]  Willey, C.J., Coppo, R., Schaefer, F., Mizerska-Wasiak, M., Mathur, M. and Schultz, M.J. (2023) The Incidence and Prevalence of IgA Nephropathy in Europe. Nephrology Dialysis Transplantation, 38, 2340-2349.
https://doi.org/10.1093/ndt/gfad082
[4]  Lee, H., Kim, D.K., Oh, K., Joo, K.W., Kim, Y.S., Chae, D., et al. (2012) Mortality of IgA Nephropathy Patients: A Single Center Experience over 30 Years. PLOS ONE, 7, e51225.
https://doi.org/10.1371/journal.pone.0051225
[5]  Knoop, T., Vikse, B.E., Svarstad, E., Leh, S., Reis?ter, A.V. and Bj?rneklett, R. (2013) Mortality in Patients with IgA Nephropathy. American Journal of Kidney Diseases, 62, 883-890.
https://doi.org/10.1053/j.ajkd.2013.04.019
[6]  Hastings, M.C., Bursac, Z., Julian, B.A., Villa Baca, E., Featherston, J., Woodford, S.Y., et al. (2018) Life Expectancy for Patients from the Southeastern United States with IgA Nephropathy. Kidney International Reports, 3, 99-104.
https://doi.org/10.1016/j.ekir.2017.08.008
[7]  Jarrick, S., Lundberg, S., Welander, A., Carrero, J., H?ijer, J., Bottai, M., et al. (2019) Mortality in IgA Nephropathy: A Nationwide Population-Based Cohort Study. Journal of the American Society of Nephrology, 30, 866-876.
https://doi.org/10.1681/asn.2018101017
[8]  Hassler, J.R. (2020) IgA Nephropathy: A Brief Review. Seminars in Diagnostic Pathology, 37, 143-147.
https://doi.org/10.1053/j.semdp.2020.03.001
[9]  Stamellou, E., Seikrit, C., Tang, S.C.W., Boor, P., Tesa?, V., Floege, J., et al. (2023) IgA Nephropathy. Nature Reviews Disease Primers, 9, Article No. 67.
https://doi.org/10.1038/s41572-023-00476-9
[10]  Ghani, A.A., Al Waheeb, S., Al Homoud, E., Al Helal, B. and Hussain, N. (2011) Clinical and Histopathological Spectrum of IgA Nephropathy in Kuwait. Annals of Saudi Medicine, 31, 152-157.
https://doi.org/10.4103/0256-4947.77491
[11]  Alwahaibi, N., Al-Khazimi, O. and Al-Riyami, M. (2022) Histopathological Spectrum of Glomerular Diseases in Oman: A Five-Year Study. Saudi Journal of Kidney Diseases and Transplantation, 33, 425-431.
https://doi.org/10.4103/1319-2442.385966
[12]  Arrayed, A.A., Shariff, S. and Maamari, M.M.A. (2007) Kidney Disease in Bahrain: A Biopsy-Based Epidemiological Study. Transplantation Proceedings, 39, 875-878.
https://doi.org/10.1016/j.transproceed.2007.03.079
[13]  Mitwalli, A.H. (2000) Glomerulonephritis in Saudi Arabia: A Review. Saudi Journal of Kidney Diseases and Transplantation, 11, 567-576.
[14]  Yahya, T.M., Pingle, A., Boobes, Y. and Pingle, S. (1998) Analysis of 490 Kidney Biopsies: Data from the United Arab Emirates Renal Diseases Registry. Journal of Nephrology, 11, 148-150.
[15]  Alhadari, A.K., Alalawi, F.J., Seddik, A.A., Zahra, K., Kumar, D., Yousif, H., et al. (2017) Pattern of Acute Glomerulonephritis in Adult Population in Dubai: A Single-Center Experience. Saudi Journal of Kidney Diseases and Transplantation, 28, 571-578.
https://doi.org/10.4103/1319-2442.206443
[16]  Al Shamsi, H., El Tahrawi, R., Hindawy, B., Khater, E. and Hassan, M. (2020) Multicenter Review of Glomerular Diseases in the Emirates of Abu Dhabi: Six Years’ Experience. Saudi Journal of Kidney Diseases and Transplantation, 31, 1069-1077.
https://doi.org/10.4103/1319-2442.301173
[17]  Rovin, B.H., Barratt, J., Cook, H.T., Noronha, I.L., Reich, H.N., Suzuki, Y., et al. (2025) KDIGO 2025 Clinical Practice Guideline for the Management of Immunoglobulin A Nephropathy (IgAN) and Immunoglobulin A Vasculitis (IgAV). Kidney International, 108, S1-S71.
https://doi.org/10.1016/j.kint.2025.04.004
[18]  Ramsawak, S., Cohen, S., Linares, A. and Cavanaugh, C. (2025) IgA Nephropathy: Update on Pathogenesis and Treatment. Cleveland Clinic Journal of Medicine, 92, 373-383.
https://doi.org/10.3949/ccjm.92a.24105
[19]  Aseem, S. and Zheng, S. (2024) Immunoglobulin A Nephropathy: A Review. The Permanente Journal, 28, 87-94.
https://doi.org/10.7812/tpp/24.089
[20]  Wyatt, R.J. and Julian, B.A. (2013) IgA Nephropathy. New England Journal of Medicine, 368, 2402-2414.
https://doi.org/10.1056/nejmra1206793
[21]  Gliklich, R.E., Dreyer, N.A. and Leavy, M.B. (2014) Patient Registries. Registries for Evaluating Patient Outcomes: A User’s Guide. 3rd Edition, Agency for Healthcare Research and Quality (US).
[22]  Rauen, T., Eitner, F., Fitzner, C., Sommerer, C., Zeier, M., Otte, B., et al. (2015) Intensive Supportive Care Plus Immunosuppression in IgA Nephropathy. New England Journal of Medicine, 373, 2225-2236.
https://doi.org/10.1056/nejmoa1415463
[23]  Rauen, T., Wied, S., Fitzner, C., Eitner, F., Sommerer, C., Zeier, M., et al. (2020) After Ten Years of Follow-Up, No Difference between Supportive Care Plus Immunosuppression and Supportive Care Alone in IgA Nephropathy. Kidney International, 98, 1044-1052.
https://doi.org/10.1016/j.kint.2020.04.046
[24]  Lv, J., Wong, M.G., Hladunewich, M.A., Jha, V., Hooi, L.S., Monaghan, H., et al. (2022) Effect of Oral Methylprednisolone on Decline in Kidney Function or Kidney Failure in Patients with IgA Nephropathy: The TESTING Randomized Clinical Trial. JAMA, 327, 1888-1898.
https://doi.org/10.1001/jama.2022.5368
[25]  Stamellou, E., Bruchfeld, A., Caravaca-Fontan, F., Frangou, E., Kronbichler, A., Mirioglu, S., et al. (2025) The 2025 KDIGO IgA Nephropathy Guideline Update: An ERA Immunonephrology Working Group Perspective. Clinical Kidney Journal, 18, sfaf324.
https://doi.org/10.1093/ckj/sfaf324
[26]  Wang, H., He, L., Feng, L., Zhang, W., Liu, N. and Zhang, W. (2024) Non-Invasive Assessment of IgA Nephropathy Severity with [18F]AlF-NOTA-FAPI-04 PET/CT Imaging. Clinical Kidney Journal, 17, sfae340.
https://doi.org/10.1093/ckj/sfae340
[27]  Klinkhammer, B.M., Lammers, T., Mottaghy, F.M., Kiessling, F., Floege, J. and Boor, P. (2021) Non-Invasive Molecular Imaging of Kidney Diseases. Nature Reviews Nephrology, 17, 688-703.
https://doi.org/10.1038/s41581-021-00440-4
[28]  Barratt, J., Lafayette, R.A. and Floege, J. (2024) Therapy of IgA Nephropathy: Time for a Paradigm Change. Frontiers in Medicine, 11, Article ID: 1461879.
https://doi.org/10.3389/fmed.2024.1461879
[29]  Lafayette, R., Kristensen, J., Stone, A., Floege, J., Tesa?, V., Trimarchi, H., et al. (2023) Efficacy and Safety of a Targeted-Release Formulation of Budesonide in Patients with Primary IgA Nephropathy (NefIgArd): 2-Year Results from a Randomised Phase 3 Trial. The Lancet, 402, 859-870.
https://doi.org/10.1016/s0140-6736(23)01554-4
[30]  Barratt, J., Lafayette, R., Kristensen, J., Stone, A., Cattran, D., Floege, J., et al. (2023) Results from Part a of the Multi-Center, Double-Blind, Randomized, Placebo-Controlled NefIgArd Trial, Which Evaluated Targeted-Release Formulation of Budesonide for the Treatment of Primary Immunoglobulin a Nephropathy. Kidney International, 103, 391-402.
https://doi.org/10.1016/j.kint.2022.09.017
[31]  Yang, Y. and Xu, G. (2025) Opportunities and Challenges in the Treatment of IgA Nephropathy. Frontiers in Pharmacology, 16, Article ID: 1559593.
https://doi.org/10.3389/fphar.2025.1559593
[32]  Coppo, R. (2025) Treating IgA Nephropathy: Looking at the Future without Forgetting the Past. Journal of Clinical Medicine, 14, Article No. 4045.
https://doi.org/10.3390/jcm14124045
[33]  Rovin, B.H., Barratt, J., Heerspink, H.J.L., Alpers, C.E., Bieler, S., Chae, D., et al. (2023) Efficacy and Safety of Sparsentan versus Irbesartan in Patients with IgA Nephropathy (PROTECT): 2-Year Results from a Randomised, Active-Controlled, Phase 3 Trial. The Lancet, 402, 2077-2090.
https://doi.org/10.1016/s0140-6736(23)02302-4
[34]  Heerspink, H.J.L., Stefánsson, B.V., Correa-Rotter, R., Chertow, G.M., Greene, T., Hou, F., et al. (2020) Dapagliflozin in Patients with Chronic Kidney Disease. New England Journal of Medicine, 383, 1436-1446.
https://doi.org/10.1056/nejmoa2024816
[35]  The EMPA-KIDNEY Collaborative Group (2023) Empagliflozin in Patients with Chronic Kidney Disease. New England Journal of Medicine, 388, 117-127.
https://doi.org/10.1056/nejmoa2204233
[36]  Heerspink, H.J.L., Jardine, M., Kohan, D.E., Lafayette, R.A., Levin, A., Liew, A., et al. (2025) Atrasentan in Patients with IgA Nephropathy. New England Journal of Medicine, 392, 544-554.
https://doi.org/10.1056/nejmoa2409415
[37]  Perkovic, V., Barratt, J., Rovin, B., Kashihara, N., Maes, B., Zhang, H., et al. (2025) Alternative Complement Pathway Inhibition with Iptacopan in IgA Nephropathy. New England Journal of Medicine, 392, 531-543.
https://doi.org/10.1056/nejmoa2410316
[38]  Perkovic, V., Trimarchi, H., Tesar, V., Lafayette, R., Wong, M.G., Barratt, J., et al. (2026) Sibeprenlimab in IgA Nephropathy—Interim Analysis of a Phase 3 Trial. New England Journal of Medicine, 394, 635-646.
https://doi.org/10.1056/nejmoa2512133
[39]  Lafayette, R., Barbour, S.J., Brenner, R.M., Campbell, K.N., Doan, T., Eren, N., et al. (2026) A Phase 3 Trial of Atacicept in Patients with IgA Nephropathy. New England Journal of Medicine, 394, 647-657.
https://doi.org/10.1056/nejmoa2510198

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