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Setting: Patients recruited from 32 nephrology centres in Germany.
Patients: Any patient aged 18–70 years, with confirmed IgA nephropathy on biopsy, with proteinuria (>0.75 g/day), and hypertension (>139/89 mm Hg) or impaired renal function (estimated glomerular filtration rate end stage renal failure (eGFR) <90 mL/min/1.73 m2) or both.
Intervention: All patients joining the study had an initial 6 months ‘run-in’ period during which they received smoking cessation, non-steroidal anti-inflammatory drug avoidance, dietary advice and statins to reduce cholesterol to <5.2 mmol/L; and ACE inhibitor or angiotensin receptor blocker, to reduce proteinuria and hypertension.
If the proteinuria persisted (>0.75 and <3.5 g/day), participants were randomised to supportive treatment or one …
Correspondence to Dr Alexander D Lalayiannis, Nephrology Department, Birmingham Children's Hospital, Birmingham B4 6NH, UK;