In North America, IgA nephropathy (IgAN) affects men about twice as often as women, and men may also face greater risk of kidney function decline. The reasons remain uncertain, but Ramy Hanna, MD, points to possible interactions among sex hormones, mucosal immunity, genetics, epigenetics, and environmental factors. Potential explanations include protective effects of estrogen, adverse effects of testosterone, or sex-related differences in IgA galactosylation, but these hypotheses require further study.
Earlier recognition remains a major clinical challenge. Proteinuria and hematuria—particularly in younger patients and especially men—should prompt careful evaluation, yet IgAN can remain undetected until kidney damage has progressed. Kidney biopsy remains the diagnostic gold standard, while evolving guidelines increasingly support considering biopsy at lower levels of proteinuria than traditionally used. Hanna also highlighted barriers to adoption of newer IgAN treatments, including cost, insurance coverage, therapeutic inertia, and the need for greater clinician education.
Reference: Persaud N. Ramy Hanna, MD, Discusses IgA Nephropathy Prevalence in Men. Renal and Urology News. Published July 30, 2026. Accessed August 25, 2026. https://www.renalandurologynews.com/features/ramy-hanna-md-iga-nephropathy-prevalence-men-treatment-risk-interview/
