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IgA nephropathy

Last reviewed: 4 Sep 2023
Last updated: 01 Feb 2022



History and exam

Key diagnostic factors

  • hematuria
More key diagnostic factors

Other diagnostic factors

  • proteinuria
  • hypertension
  • edema
Other diagnostic factors

Risk factors

  • family history of IgAN
  • male sex
  • age 20 to 30 years
  • Asian/white/native American ancestry
  • IgA vasculitis
  • chronic liver disease
  • HIV infection
More risk factors

Diagnostic investigations

1st investigations to order

  • urinalysis
  • urine microscopy and culture
  • basic biochemistry, including estimated glomerular filtration rate (GFR)
  • C3 and C4 complement levels
  • kidney ultrasound
  • computed tomography (KUB)
  • kidney biopsy
More 1st investigations to order

Investigations to consider

  • flexible cystoscopy
  • skin biopsy
More investigations to consider

Treatment algorithm


low risk of progression

medium risk of progression

high risk of progression

acute kidney injury



Jonathan Barratt, PhD, FRCP

The Mayer Professor of Renal Medicine

Department of Cardiovascular Sciences

University of Leicester

Honorary Consultant Nephrologist

John Walls Renal Unit

Leicester General Hospital



JB has consultancies with Alnylam, argenx, Astellas, Calliditas, Chinook, Dimerix, Novartis, Omeros, Travere Therapeutics, Vera Therapeutics and Visterra. He is also an author of a number of references cited in this topic.

See Cheng Yeo, MBBS, M.Med (Int Med), FRCP (London), MD

Adjunct Assistant Professor

Head & Senior Consultant

Department of Renal Medicine

Tan Tock Seng Hospital



SCY is an author of a reference cited in this topic.


Professor Jonathan Barratt and Dr See Cheng Yeo would like to gratefully acknowledge Dr Hani Bleibel and Dr Chike Nzerue, previous contributors to this topic.


HB and CN declare that they have no competing interests.

Peer reviewers

Richard Lafayette, MD

Associate Professor of Medicine

Nephrology Division

Stanford University Medical Center




RL declares that he has no competing interests.

Alan Salama, MA, MBBS, PhD, FRCP

Professor of Nephrology

UCL Centre for Nephrology

Royal Free Hospital




AS declares that he has no competing interests.

  • IgA nephropathy images
  • Differentials

    • IgA vasculitis (previously known as Henoch-Schönlein purpura [HSP])
    • Thin glomerular basement membrane disease
    • Alport syndrome
    More Differentials
  • Guidelines

    • KDIGO 2021 clinical practice guidelines for the management of glomerular diseases
    More Guidelines
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