Abstract: FR-PO0847
KDIGO Spoke, Nephrologists Listened: Treatment Paradigms Are Already Shifting
Session Information
- Glomerular Diseases: Practice and New Concepts Shaping Modern Care
October 23, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Glomerular Diseases
- 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics
Authors
- McClatchy, Ellie, Spherix Global Insights, Eagleview, Pennsylvania, United States
- McCarthy, Kari, Spherix Global Insights, Eagleview, Pennsylvania, United States
- Newton, Shaunna, Spherix Global Insights, Eagleview, Pennsylvania, United States
Background
KDIGO guidelines have acted as a global reference standard for nephrologists, aiming to improve kidney care and patient outcomes, for decades. More recently in 2024, KDIGO rolled out guideline updates, which were later finalized and published at the end of 2025. These updates include many of the new treatment options available in the rapidly evolving treatment landscape of glomerular diseases.
Methods
Opinion data was collected in August 2025 from 103 US-based nephrologists via online survey. KDIGO perceptions data were collected in October 2025 via a brief online survey in partnership with 91 US-based nephrologists. Supplemental nephrologist opinions data was collected in February 2026 from an additional 105 US-based nephrologists using an online survey.
Results
In reaction to the publication of the final KDIGO guidelines, roughly one-half of nephrologists agreed that it has become a more relevant guide for their personal IgAN treatment protocols. Nearly 9 in 10 nephrologists anticipated the guideline would impact their IgAN management strategy, specifically through earlier use of SGLT2 inhibitors and increased use of branded targeted therapies such as sparsentan and budesonide.
By Q1 2026, self-reported treatment beliefs reflected these anticipated changes. Ideal use of SGLT2 inhibitors as first-line therapy increased substantially from 42% to 65%, while second-line positioning declined, highlighting the shift from second line to foundational usage. During the same period, budesonide, sparsentan, and atrasentan all saw sharp increases in second-line positioning.
Nephrologists also demonstrated increasing alignment with KDIGO treatment goals. Following the guideline’s publication, 77% agreed that simultaneous use of new branded therapies may be necessary to achieve KDIGO treatment targets, and physicians increasingly identified proteinuria reduction below 0.3g/day as a benchmark of optimal disease management.
Conclusion
Publication of the final 2025 KDIGO IgAN guideline accelerated earlier and more aggressive treatment strategies, characterized by foundational SGLT2 inhibitor use and expanded adoption of targeted branded therapies. These findings suggest the updated guideline is influencing real-world IgAN treatment choices and reinforcing aggressive and proteinuria-driven management approaches.