Residual Risk in IgAN: The Emerging Roles for Endothelin Modulation

This topic will address the ongoing challenge of residual risk in IgAN despite optimised supportive care, including RAAS blockade and SGLT2 inhibition. The talk will focus on the endothelin‑1/endothelin A receptor pathway as an important contributor to persistent proteinuria, glomerular injury, inflammation, and fibrosis. Clinical trial evidence and meta‑analyses supporting the proteinuria‑lowering effects of endothelin receptor antagonists will be reviewed. Building on the treat‑to‑target framework introduced in Topic 1, this presentation will examine the emerging role of multi‑pathway therapy in IgAN and discuss how updates from the KDIGO 2025 guideline support a broader therapeutic strategy to address residual risk and improve long‑term kidney outcomes.

Professor Dr Lim Soo Kun Speaker

This topic will address the ongoing challenge of residual risk in IgAN despite optimised supportive care, including RAAS blockade and SGLT2 inhibition. The talk will focus on the endothelin‑1/endothelin A receptor pathway as an important contributor to persistent proteinuria, glomerular injury, inflammation, and fibrosis. Clinical trial evidence and meta‑analyses supporting the proteinuria‑lowering effects of endothelin receptor antagonists will be reviewed. Building on the treat‑to‑target framework introduced in Topic 1, this presentation will examine the emerging role of multi‑pathway therapy in IgAN and discuss how updates from the KDIGO 2025 guideline support a broader therapeutic strategy to address residual risk and improve long‑term kidney outcomes.