{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T04:52:04Z","timestamp":1791348724490,"version":"4.3.1"},"reference-count":63,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>Immunoglobulin A nephropathy (IgAN) is a kidney disease characterized by deposition of galactose-deficient IgA1-containing immune complexes in the glomerular mesangium. It is the most common primary glomerular disease worldwide, affecting approximately 2.5 persons per 100,000 population annually. A definitive IgAN diagnosis requires a kidney biopsy. However, non-specific clinical signs, limited disease awareness, and lack of validated biomarkers can delay nephrology referral from primary care providers, prolonging time to diagnosis and negatively impacting patient outcomes. In this perspective, we aim to raise awareness of the importance of timely kidney biopsy in IgAN. To do so, we first outline the key clinical features of IgAN and kidney biopsy indications that should prompt nephrology referral. Subsequently, we highlight the diagnostic and prognostic significance of kidney biopsy findings, examine barriers to kidney biopsy completion, and provide our outlook on the ways in which kidney biopsy may be useful for IgAN management in the future.<\/jats:p>","DOI":"10.3389\/fmed.2026.1882638","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T04:48:24Z","timestamp":1791348504000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Kidney biopsy in the diagnosis of immunoglobulin A nephropathy"],"prefix":"10.3389","volume":"13","author":[{"given":"Kirk N.","family":"Campbell","sequence":"first","affiliation":[{"name":"Division of Renal-Electrolyte and Hypertension, University of Pennsylvania Perelman School of Medicine","place":["Philadelphia, PA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Pathology, The University of Chicago","place":["Chicago, IL, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"Vivarelli","sequence":"additional","affiliation":[{"name":"Clinical Trial Center and Laboratory of Nephrology, Bambino Ges\u00f9 Children's Hospital IRCCS","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,10,7]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"16001","DOI":"10.1038\/nrdp.2016.1","article-title":"IgA nephropathy","volume":"2","author":"Lai","year":"2016","journal-title":"Nat Rev Dis Primers"},{"key":"B2","doi-asserted-by":"publisher","first-page":"947","DOI":"10.3390\/jcm13040947","article-title":"An update on current therapeutic options in IgA nephropathy","volume":"13","author":"Lim","year":"2024","journal-title":"J Clin Med"},{"key":"B3","doi-asserted-by":"publisher","first-page":"S1","DOI":"10.1016\/j.kint.2025.04.004","article-title":"KDIGO 2025 Clinical Practice Guideline for the Management of Immunoglobulin A Nephropathy (IgAN) and Immunoglobulin A Vasculitis (IgAV)","volume":"108","author":"Rovin","year":"2025","journal-title":"Kidney Int"},{"key":"B4","doi-asserted-by":"publisher","first-page":"727","DOI":"10.2215\/CJN.0000000000000135","article-title":"Long-term outcomes in IgA nephropathy","volume":"18","author":"Pitcher","year":"2023","journal-title":"Clin J Am Soc Nephrol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1038\/ki.2015.322","article-title":"The MEST score provides earlier risk prediction in IgA nephropathy","volume":"89","author":"Barbour","year":"2016","journal-title":"Kidney Int"},{"key":"B6","doi-asserted-by":"publisher","first-page":"36","DOI":"10.36469\/001c.26129","article-title":"A systematic literature review of the epidemiology, health-related quality of life impact, and economic burden of immunoglobulin A nephropathy","volume":"8","author":"Kwon","year":"2021","journal-title":"J Health Econ Outcomes Res"},{"key":"B7","doi-asserted-by":"publisher","first-page":"414","DOI":"10.1093\/ndt\/gfq665","article-title":"The incidence of primary glomerulonephritis worldwide: a systematic review of the literature","volume":"26","author":"McGrogan","year":"2011","journal-title":"Nephrol Dial Transplant"},{"key":"B8","doi-asserted-by":"publisher","first-page":"533","DOI":"10.1007\/s00467-024-06502-6","article-title":"IPNA clinical practice recommendations for the diagnosis and management of children with IgA nephropathy and IgA vasculitis nephritis","volume":"40","author":"Vivarelli","year":"2025","journal-title":"Pediatr Nephrol"},{"key":"B9","article-title":"Real-world analysis of patients with immunoglobulin A nephropathy \u2013 diagnosis and disease monitoring","volume-title":"Poster presented at: ISN World Congress of Nephrology; (2024) Apr 13\u201316; Buenos Aires, Argentina. 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