Treating Patients with IgA Nephropathy

Immunoglobulin A (IgA) nephropathy is the most common form of glomerulonephritis, but various aspects of treatment remain controversial. In this study, German researchers identified 162 patients with high-risk IgA nephropathy who already were treated with renin–angiotensin-system blockers and who had substantial proteinuria (≥0.75 but <3.5 g/day) and estimated glomerular filtration rates (eGFRs) between 30 and 90 mL/minute/1.73m². Patients were randomized to receive either continued intensive supportive care alone or intensive supportive care plus immunosuppression. In the immunosuppression group, patients with eGFRs ≥60 mL/minute/1.73m² received glucocorticoid monotherapy for 6 months, and those with eGFRs between 30 and 59 mL/minute/1.73m…