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Author Spotlight: Investigating the Potential of Chinese Herbal Medicinal Active Dioscin in Treating IgA Nephropathy
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Sex Differences Across Corticosteroid Response and Outcomes in IgA Nephropathy
Dana Kim1,2, Mark Woodward1,3, Jicheng Lv4
1The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia.
Kidney International Reports
|October 27, 2025
Summary
Corticosteroid treatment benefits IgA nephropathy (IgAN) patients regardless of sex. However, males with IgAN face worse kidney outcomes than females, indicating a need for sex-specific considerations in IgAN management.
Area of Science:
- Nephrology
- Immunology
- Clinical Trials
Background:
- The impact of sex on treatment response and outcomes in IgA nephropathy (IgAN) is not well understood.
- IgAN is a leading cause of primary glomerulonephritis worldwide.
Purpose of the Study:
- To evaluate the effect of sex on corticosteroid response in IgAN patients.
- To determine the association between sex and kidney outcomes in IgAN.
Main Methods:
- Analysis of the Therapeutic Effects of Steroids in IgAN Global (TESTING) trial data.
- Randomization of IgAN patients to methylprednisolone or placebo for 6-9 months.
- Primary outcome: composite of 40% eGFR decline, kidney failure, or death; secondary outcomes included proteinuria and eGFR slope.
Main Results:
- Methylprednisolone reduced the primary outcome risk in both males and females without significant sex interaction (P=0.47).
- No sex differences were observed in proteinuria reduction (P=0.28) or eGFR decline (P=0.81) with treatment.
- Males exhibited a higher risk of the primary outcome (HR=1.44, P=0.03) and a faster eGFR decline (3.13 ml/min/1.73 m²/yr, P=0.006) compared to females.
Conclusions:
- Methylprednisolone improves kidney outcomes in IgAN patients irrespective of sex.
- Males with IgAN experience poorer kidney outcomes and faster disease progression than females.
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