Study question

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 …