Given that the majority of patients with IgA nephropathy are asymptomatic, current guidelines suggest initial management measures aimed at reducing proteinuria and disease progression. Some guidelines recommend the use of sodium-glucose cotransporter-2 inhibitors (iSGLT-2). Although factors such as proteinuria > 0.7 g/24 hrs, hypertension, and decreased glomerular filtration rate at the time of diagnosis are considered high risk, the use of immunosuppressive therapy in these situations is still controversial.
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Hernández et al. (2024) studied this question.
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