How many years can IgA nephropathy grade 4 live needs to be judged according to the patient’s age, underlying diseases and complications, and not generalized. The 10-year renal survival rate of IgA nephropathy is 80%~85%, and the 20-year rate is about 65%. However, there is a great individual difference, some patients have a good long-term prognosis, which may not affect their life expectancy, but some patients have a rapid progression to renal failure, which leads to a shorter life expectancy. IgA nephropathy grade 4 may manifest as hematuria, proteinuria, hypertension or renal impairment. If the patient has no underlying disease and no obvious complications, active control of blood pressure, reduce proteinuria and other treatments can slow down the progression of kidney disease, there is no life-threatening possibility, the exact length of life can not be clear. If the patient is elderly, there are hypertension, diabetes, coronary heart disease and other underlying diseases, or serious complications such as cardiovascular disease, its prognosis is poorer, and the patient may soon progress to uremia, serious life-threatening, at this time may affect life expectancy. Patients with IgA nephropathy grade 4 are recommended to go to regular hospitals in time and receive standardized treatment under the guidance of doctors.