Glomerular disease

Immunosuppressant-induced reduction of proteinuria in IgAN

Time-averaged proteinuria (TAP) is thought to be the most reliable predictor of outcomes in IgA nephropathy (IgAN). New data suggest that corticosteroids reduce TAP and presumably improve outcomes in IgAN, but increase the risk of adverse effects. Whether TAP is a good surrogate end point for clinical trials remains unclear.

Access options

Rent or Buy article

Get time limited or full article access on ReadCube.


All prices are NET prices.

Figure 1: Trial-level assessment of the validity of proteinuria as a surrogate end point in IgAN.


  1. 1

    International Society of Nephrology. KDIGO Clinical Practice Guideline for Glomerulonephritis. Kidney Int. Suppl. 2, 139–274 (2012)

  2. 2

    Reich, H. N., Troyanov, S., Scholey, J. W., Cattran, D. C. & Toronto Glomerulonephritis Registry. Remission of proteinuria improves prognosis in IgA nephropathy. J. Am. Soc. Nephrol. 18, 3177–3183 (2007).

    CAS  Article  Google Scholar 

  3. 3

    Sarcina, C. et al. Changes in proteinuria and side effects of corticosteroids alone or in combination with azathioprine at different stages of IgA nephropathy. Clin. J. Am. Soc. Nephrol., (2016).

  4. 4

    Pozzi, C. et al. Corticosteroid effectiveness in IgA nephropathy: long-term results of a randomized, controlled trial. J. Am. Soc. Nephrol. 15, 157–163 (2004).

    CAS  Article  Google Scholar 

  5. 5

    Rauen, T. et al. Intensive supportive care plus immunosuppression in IgA nephropathy. N. Engl. J. Med. 373, 2225–2236 (2015).

    CAS  Article  Google Scholar 

  6. 6

    Inker, L. A. et al. Early change in urine protein as a surrogate end point in studies of IgA nephropathy: an individual-patient meta-analysis. Am. J. Kidney Dis., (2016).

  7. 7

    Donadio, J. V. et al. A controlled trial of fish oil in IgA nephropathy. N. Engl. J. Med. 331, 1194–1199 (1994).

    Article  Google Scholar 

  8. 8

    Nomura, A. et al. Role of complement in acute tubulointerstitial injury of rats with aminonucleoside nephrosis. Am. J. Pathol. 151, 539–547 (1997).

    CAS  PubMed  PubMed Central  Google Scholar 

  9. 9

    US National Library of Science., (2016).

Download references

Author information



Corresponding author

Correspondence to Jürgen Floege.

Ethics declarations

Competing interests

The authors declare no competing financial interests.

PowerPoint slides

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Floege, J., Rauen, T. Immunosuppressant-induced reduction of proteinuria in IgAN. Nat Rev Nephrol 12, 380–382 (2016).

Download citation

Further reading


Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing