IgA nephropathy (IgAN) is the most prevalent primary glomerulonephritis globally and a leading cause of kidney failure in individuals under 40 years of age.1 Persistent proteinuria, hypertension, reduced baseline estimated glomerular filtration rate (eGFR), and Oxford classification scores are key predictors of kidney progression.2 Hematuria occurs in 70-100% of patients, usually microscopic and sometimes macroscopic after infections.3 Its prognostic value remains uncertain because prior studies report inconsistent results and often rely on single time-point measurements; evidence from randomized trials is limited, even for time-averaged (TA) hematuria.