Some of the factors that affect the long term prognosis of patients with IgA nephropathy depends on the findings at presentation. If the kidney function is normal, blood pressure is normal and the protein leakage is minimal (less than 0.5 g per day) they do have a good prognosis.
Some of these patients can go into remission, that is, they have no protein leakage. The long term risk for kidney failure in patients with minimal protein leakage is about 40 to 50% at 30 years. Those who don't develop increase in the protein leakage, increase in blood pressure or reduction of kidney function during the long term follow up are those who continue to avoid kidney failure in the future, that is, beyond 30 years.
Finally, dialysis or kidney transplantation doesn't treat IgA nephropathy. It is treatment for kidney failure, that is, when the kidneys have stopped working.
Sincerely
Dr Pary Sivaraman