Immunoglobulin A （IgA） nephropathy is a primary glomerular disease characterized by predominant IgA or IgA deposition in the mesangial region of the glomerulus. The currently widely recognized "multiple-hits" theory of pathogenesis corresponds with the traditional Chinese medicine （TCM） concept of "latent pathogen in the pleurodiaphragmatic interspace". Patients often have congenital deficiency and mucosal immune defects of the

Sanjiao

. Latent pathogenic factors of wind， dampness， and heat reside in the pleurodiaphragmatic interspace of the

Sanjiao

and kidney， resulting in impaired permeability of the interspace， disrupte

d

qi

transformation of the

Zangfu

organs， and disharmony of the

Sanjiao

， ultimately driving the onset of IgA nephropathy. Treatment should follow the principles of eliminating latent pathogens， regulating the

Sanjiao

， and restoring permeability of the interspace. During the acute stage， therapy focuses on dispersing the latent pathogens causing stagnation in the

Sanjiao

. In the chronic persistent stage， the approach emphasizes strengthening healthy

qi

while also addressing residual pathogens， with attention to the effects of proteinuria on syndromes. In the stage of renal function decline， treatment centers on reinforcing healthy

qi

， tonifying the kidney， combined with removing blood stasis and eliminating turbidity. Therapy should be guided by disease stage and syndrome differentiation， with the goals of dispersing latent pathogens， restoring interspace permeability， harmonizing the

Sanjiao

， recovering kidney

qi

transformation， and slowing disease progression.