IgA肾病是最常见的肾小球疾病，目前仍然是导致我国终末期肾病的最重要原因。起病后10年约20%的患者进展至终末期肾病。但是由于IgA肾病病因不清，发病机制与多种因素有关，临床、病理表现的多样化及预后的异质性，迄今为止，对于IgA肾病尚无特效的治疗方法。临床治疗主要是缓解症状和延缓病情进展，包括一般治疗如饮食限制、血压控制、RAS阻断剂的应用等。IgA肾病中是否应该使用糖皮质激素、免疫抑制治疗和扁桃体切除等，临床上还缺少支持临床决策的高质量证据，关于这个问题的国际共识也是缺乏的。本文就当前有关IgA肾病的治疗新进展做一述评。

IgA nephropathy (IgAN)is the most common glomerular disease and the leading cause of end-stage renal disease (ESRD) in China. About 20% of IgAN patients will progress to ESRD 10 years after the onset. For the unclear causes, a variety of pathogenesis, diversity of clinical pathological manifestations, and heterogeneity of prognosis in IgAN, there is a lack of special treatment up to now. Dietary restrictions, blood pressure control, and RAS inhibition remain the cornerstone management to retard disease progression in IgAN. The use of corticosteroids, immunosuppressants, and tonsillectomy in IgAN remains controversial, and there is a dearth of high quality evidence for clinical decisions. International consensus on this issue is still lacking. The current status of diagnosis and treatment of IgAN will be discussed in this commentary.