IgA nephropathy grade IV is generally more serious. IgA nephropathy is a glomerular disease in which IgA or IgA deposits predominate in the glomerular tunica albuginea region, and it is the most common primary glomerular disease worldwide. IgA nephropathy usually has no specific clinical symptoms, and some patients may have symptoms such as low back pain and abdominal pain, and even some patients may have symptoms such as edema, hypertension, oliguria and rapid deterioration of renal function. In general, patients need to actively improve the kidney-related examination, and if there is severe renal function impairment, they need to actively standardize the treatment to avoid further deterioration of the condition and progression to uremia stage. In IgA nephropathy grade IV, glomerular lesions are mostly severe diffuse thylakoid proliferation and sclerosis, some or all glomerulosclerosis, visible crescent (<45%). Renal tubular atrophy, renal interstitial infiltration, occasionally see renal interstitial foam cells, at this time the condition is generally more serious. It is recommended that patients pay attention to it and seek medical treatment in time. It is recommended that patients with IgA nephropathy grade IV should seek timely medical treatment and follow the doctor’s instructions for standardized diagnosis and treatment.