Immunoglobulin A nephropathy (IgAN) represents the predominant glomerulonephritis globally and is a leading cause of chronic kidney disease (CKD) and end-stage renal disease (ESRD). Historically, supportive management, with blood pressure control, renal angiotensin system (RAS) blockade, and active management with steroids, has been tried. However, the treatment landscape has recently become more complex with the introduction of several highly specific therapies. This review aims to provide an in-depth overview of the latest developments in IgAN management, including traditional supportive care and exposure to novel and specific treatments.

Background: Baclofen is a centrally acting muscle relaxant used orally and intrathecally for the management of spasticity, muscular spasms, and refractory hiccups. Baclofen is predominantly absorbed via the gastrointestinal tract, with over 80% excreted via the kidneys; hence, individuals with end‐stage renal disease (ESRD) are at a heightened risk for baclofen toxicity. Baclofen can penetrate the blood–brain barrier, resulting in neurotoxicity. The potential of baclofen to induce acute pancreatitis is inadequately comprehended, with a limited number of instances documented in the medical literature. This report details an uncommon instance of an ESRD patient undergoing hemodialysis who had both baclofen‐induced neurotoxicity and pancreatitis. Case Presentation: We present a case of a 55‐year‐old woman who is known to have ESRD; she is currently on hemodialysis three times a week. After only two baclofen doses (10 mg, 12 h apart), given for chronic cervical pain, the patient developed a profound decrease in her level of consciousness (LOC). The next day, when her LOC had improved after dialysis, she reported nausea, vomiting, and epigastric abdominal pain as well. Her initial laboratory report showed an elevated amylase level. So, the assessment was a baclofen neurotoxicity in an ESRD patient, which was accompanied by mild–moderate pancreatitis after only two doses. Since baclofen is highly dialyzable, she was commenced on daily conventional hemodialysis using a high‐flux dialyzer for three consecutive days. She did not require continuous dialysis. Her LOC improved dramatically after the second session, and she returned to her baseline just after the third session. However, she reported headache and hallucinations after. Pancreatitis symptoms improved with supportive measures later. Conclusion: The case highlights the need for increased awareness among healthcare providers about the potential risks of baclofen use, particularly in patients with ESRD. Even a small dosing can cause neurotoxicity. This is a very rare case of baclofen neurotoxicity accompanied by pancreatitis, who did respond very well to conventional hemodialysis. Patients with decreased renal function should avoid using baclofen, as its accumulation depends on renal excretion capacity.

Background and Objectives: IgA nephropathy represents the most prevalent form of primary glomerulonephritis around the world, with significant heterogeneity in management strategies and outcomes. We conducted a systematic review and meta-analysis to evaluate the efficacy and safety of pharmacological interventions for IgA nephropathy. Materials and Methods: We searched multiple databases through June 2025, identifying randomized controlled trials and observational studies evaluating pharmacological treatments in biopsy-proven IgA nephropathy. Primary outcomes included proteinuria reduction and estimated glomerular filtration ration (eGFR) preservation. Secondary outcomes included hard kidney endpoints and safety parameters. Random-effects meta-analyses were performed with comprehensive risk–benefit assessments. Results: Twenty-five studies were included. B-cell/plasma-cell-targeted therapies showed significant proteinuria reduction (−34.0% [95% CI: −45.7, −22.3%]), complement pathway inhibitors demonstrated superior eGFR preservation (+5.8 mL/min/1.73 m²/year [95% CI: 2.4, 9.2]). Systemic corticosteroids showed observed hard outcome benefits (HR 0.37 [95% CI: 0.26, 0.52]) but highest adverse event risk (RR 3.28 [95% CI: 2.11, 5.09]). Novel agents showed projected favorable effects (B-cell: HR 0.38; complement: HR 0.42) pending validation. Conclusions: Novel targeted therapies, especially B-cell/plasma-cell-targeted agents and complement pathway inhibitors, show promising risk–benefit profiles. However, longer-term data and standardized eGFR slope reporting are needed to confirm these findings compared to other immunosuppressive agents.