Treatment innovation is changing what is possible in IgAN, but realising its value will require stronger connections across the care pathway. The strategic priority is not simply to add another test or treatment, but to ensure that clinically relevant kidney abnormalities are recognised, followed up and connected to specialist care without avoidable delay.

• Primary care and community teams need clear criteria for following up persistent proteinuria, haematuria or declining kidney function and referring appropriate patients.
• Nephrologists and health systems need practical, timely pathways from referral to specialist assessment and, where appropriate, kidney biopsy.
• Guideline and diagnostic innovation must continue to make escalation decisions clearer today and more precise as validated biomarkers emerge.

The opportunity is clear: shorten the path from the first signs of kidney damage to specialist diagnosis, so that more patients can benefit from treatment while there is still kidney function to protect.