u/notsolucky161

Hi everyone,

I was diagnosed with IgA nephropathy after a kidney biopsy. My biopsy had a MEST score of M1 E0 S1 T0 and mentioned a perihilar variant.

My biggest concern has always been long-term progression and whether I'm at significant risk of ESRD.

My treatment and timeline

I initially had significant proteinuria, with UPCR reaching around 1.15 g/g.

I was treated with prednisolone 40 mg, which substantially reduced my proteinuria. I eventually tapered off steroids and stopped them in February 2026.

My current kidney-protective treatment includes:

Telmisartan

Dapagliflozin (Dapa) 10 mg

Finerenone (Kerendia) 20 mg

I started Kerendia after 9 May 2026.

Recent kidney function

My recent numbers:

2 Apr 2026: creatinine 1.11, eGFR 92

8 May: creatinine 1.21, eGFR 83

5 Jun: creatinine 1.39, eGFR 70

4 Jul: creatinine 1.40, eGFR 69.7

14 Aug: creatinine 1.40, eGFR 69.65

So there was a noticeable drop in eGFR from May to June, but since June my creatinine/eGFR have been essentially completely stable.

I'm wondering whether the initial decline could have been partly related to the combination of Dapa + finerenone + telmisartan, particularly because Kerendia was started after the May test.

Proteinuria/albuminuria

This is where things have become very encouraging.

My ACR was around 1015 mg/g in March 2025.

More recently:

4 Jul 2026: ACR 27 mg/g

14 Aug 2026: ACR 30.8 mg/g

Today's urine dipstick was negative for protein and blood, with 0 RBC/HPF and no casts.

Potassium is currently 4.4.

So currently I'm around:

eGFR ~70 + ACR ~31 mg/g + negative urine protein + no hematuria + stable creatinine.

I'm actually feeling quite positive about my future now.

I'd especially like to hear from people using Dapa + Finerenone

For anyone with IgA nephropathy who has used these medications, I'd really appreciate your experiences:

1. Dapagliflozin (Dapa 10 mg):

How much did it reduce your proteinuria/albuminuria?

Did you experience an initial eGFR drop?

Did your eGFR stabilize afterward?

How long did it take before you noticed the full effect?

2. Finerenone (Kerendia 20 mg):

How long have you been taking 20 mg?

Did it reduce your proteinuria/ACR?

Did you experience an initial creatinine rise/eGFR drop?

Did the effect persist over time?

Did your nephrologist increase you from 10 → 20 mg, and did you notice a difference after the increase?

3. Combination therapy: For those taking Dapa + finerenone 20 mg + an ARB/ACE inhibitor, how effective has this combination been for your proteinuria?

I'm particularly interested in long-term real-world experiences, rather than just clinical-trial results.

Finally

For people who have had IgA nephropathy for 5–10+ years:

Does my current situation — eGFR around 70 but ACR around 30 mg/g and stable kidney function — look like a relatively favorable trajectory?

I'm obviously continuing regular follow-up with my nephrologist, but I'd love to hear from people who have been through a similar journey.

Thanks!

P.S. This post was written with AI but the facts and details are 100% true.

Little Context: I 28M have a govt job. My fiance has done MBA is currently employed in HR department of a reputed company. My every conditions like living in a village for sometime as I've large ancestral property, caring for my mother, becoming housewife after marriage have been accepted by the girl and her family as my job requires transfer outside India. She is nice and insanely pretty. I'm attracted to her and she's is definitely into me after about 3 months of Roka.

My issue is there is always disagreement and fighting over phone over silly things. We both have anger issues. Sometimes I instigate her and other time she instigate me. And it has become a routine. She has explicitly said that she'll never back down from placing her points. And this is just damaging this relationship.

What should I do? Should I back down and say sorry for the mistakes she is doing in order to keep the marriage afloat? Or should I stand my ground and I'm sure this will not help in the long term. Also, is this AM becoming toxic? I have no idea. Please help.

Sorry for incoherence in the post.