IgA nephropathy has made significant improvement in recent years. The successful identification of several genetic susceptibility loci, the development of the multi pathogenesis model, the adoption of the Oxford pathology scoring system, and the formalisation of the Kidney Disease Improving Global Outcomes (KDIGO) consensus treatment recommendations are some of the significant new directions and most recent developments we highlight in this article. We concentrate on the most recent genetic discoveries that support the significant role of hereditary variables and provide an explanation for some of the geoethnic differences in illness risk. The majority of IgA nephropathy susceptibility loci identified so far encode proteins involved in the upkeep of the intestinal epithelial barrier and the immune system's reaction to mucosal infections. The coordinated pattern of interpopulation allelic differentiation across all genetic loci interacts with variance in local pathogens and the incidence of the disease, pointing to a possible role for multilocus adaptation in shaping the current landscape of IgA nephropathy. Importantly, one of the new targets for potential therapeutic intervention, the "Intestinal Immune Network for IgA Production," appeared. We interpret these results in light of the multihit pathogenesis hypothesis and our current understanding of IgA immunobiology. Finally, we offer our viewpoint on the available therapeutic choices, talk about clinically ambiguous areas, and highlight ongoing clinical trials and translational investigations.
