Journal of the American Society of Nephrology
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Published ahead of print on October 17, 2007
J Am Soc Nephrol 18: 2806-2809, 2007
© 2007 American Society of Nephrology
doi: 10.1681/ASN.2007020182

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Clinical Commentary

Quantitative Appraisal of Treatment Options for IgA Nephropathy

Francis W. Ballardie

Department of Nephrology, Manchester Royal Infirmary, Manchester, United Kingdom

Correspondence: Dr. Francis W. Ballardie, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL, UK. Phone: +44-161-276-4148; Fax: +44-161-276-4129; E-mail: francis.ballardie{at}cmmc.nhs.uk or francisballardie{at}mail.com

IgA nephropathy has an impact on renal health care costs worldwide. The paucity of good clinical trials highlights the uncertainty in determining best treatment and for how long. Ongoing debate still raises questions on why opinions vary but may suggest that current data are not fully understood. The scale of benefit of immunosuppressive drugs in suppressing clinical nephritis or improving outcome is unmatched by use of renin-angiotensin inhibitors alone. By minimizing the use of immunosuppressive drugs, higher risk patients may hazard more ESRD. This review addresses how disparate views have formed, quantifying existing data, to give balance to recommendations.







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