IgA Nephropathy: A Disease in Search of a Large-Scale Clinical Trial to Reliably Inform Practice

Due to its frequency, IgA nephropathy has attracted significant scientific interest. Research has mainly covered the natural history of disease, predictive factors, and pathogenesis. Although IgA nephropathy was first identified as the pathological correlate of “benign recurrent hematuria,” it is now recognized that it is not benign, with about 15% to 40% of patients developing kidney failure within 20 years of kidney biopsy.

Identification of effective treatments for IgA nephropathy has posed challenges for the renal community, and randomized trials like the one described by Lv et al in this issue of the American Journal of Kidney Diseases are welcome additions to a sparse evidence base.