协和医学杂志2026，Vol.17Issue(2)：317-323,7.DOI:10.12290/xhyxzz.2026-0195
IgA肾病诊疗范式演变:从传统风险分层到生物标志物驱动的精准医学
Evolving Paradigms in IgA Nephropathy Management:from Traditional Risk Stratification to Biomarker-Driven Precision Medicine
摘要
Abstract
IgA nephropathy(IgAN)is the most common primary glomerulonephritis worldwide and a major cause of chronic kidney disease and kidney failure.IgAN exhibits marked heterogeneity in clinical presen-tation,histopathology,and pathogenic mechanisms,contributing to variable treatment responses and prognosis among patients.Precise risk assessment and individualized intervention are therefore of critical importance.This review systematically traces the evolution of IgAN management from traditional risk stratification toward biomar-ker-driven precision medicine.We first review the clinical utility and limitations of established risk stratification tools,including the KDIGO guidelines,the Oxford MEST-C classification,and the International IgAN Predic-tion Tool.We then discuss emerging biomarkers closely linked to disease pathogenesis,including galactose-defi-cient IgA1(Gd-IgA1),anti-Gd-IgA1 autoantibodies,B cell activating factor(BAFF),a proliferation-inducing ligand(APRIL),and complement components,as well as the targeted therapies they have informed.In addi-tion,urinary biomarkers and multi-omics approaches show promise for dynamic disease monitoring and individu-alized risk stratification.关键词
IgA肾病/精准医学/风险分层/生物标志物/靶向治疗Key words
IgA nephropathy/precision medicine/risk stratification/biomarkers/targeted therapy分类
医药卫生引用本文复制引用
王丁丁,姚萌,柳潇,翟庆娴,文琼,陈崴..IgA肾病诊疗范式演变:从传统风险分层到生物标志物驱动的精准医学[J].协和医学杂志,2026,17(2):317-323,7.基金项目
国家重点研发计划(2025YFC2511800) （2025YFC2511800）
国家自然科学基金(82370707,82570915) （82370707,82570915）
四大慢病重大专项(2023ZD0509300) （2023ZD0509300）
广东省基础与应用基础研究重大项目(基石项目)(2023B0303000013) （基石项目）
广州科技局农业和社会发展科技专题重点研发计划(2024B03J1337) National Key Research and Development Program of China(2025YFC2511800) （2024B03J1337）
National Natural Science Foun-dation of China(82370707,82570915) （82370707,82570915）
Major Project-Research on Cancer,Cardiovascular,Respiratory and Metabolic Diseases(2023ZD0509300) （2023ZD0509300）
Guangdong Major Project of Guangdong Basic and Applied Basic Research(2023B0303000013) （2023B0303000013）
Guangzhou Technology Program of Agriculture and Social Development of Key Research and Development Scheme(2024B03J1337) （2024B03J1337）
