Quantitative appraisal of treatment options for IgA nephropathy

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.