On 2017 Sep 11, NephJC - Nephrology Journal Club commented:

This randomised controlled trial of oral methylprednisolone on clinical outcomes in patients With IgA nephropathy was discussed on August 29th and September 6th 2017 on #NephJC, the open online nephrology journal club. Introductory comments written by Amit Langote are available at the NephJC website here.

As one of the commoner conditions we Nephrologists face, there was lots of interest in the controversial results of this trial.

The highlights of the tweetchat were:

• There remains some uncertainty regarding the pathogenesis of IgA Nephropathy and the disease may actually comprise a spectrum of conditions. As such treatment should likely be stratified and this limits our ability to interpret RCTs of all-comers.

• It would have been useful to see renal biopsy findings determine or influence randomization procedures.

• The fact that the population were mostly Chinese may limit the generalizability of the results to western populations.

• The GFR decline was much faster than expected or previously reported but this can be the case with certain Asian populations.

• There is a general reluctance to use steroids in the absence of crescents or rapid GFR decline among Nephrologists currently and this trial further re-enforces this sentiment. We keenly await the results from the low-TESTING trial.

Transcripts of the tweetchats, and curated versions as storify will be shortly available from the NephJC website.

Interested individuals can track and join in the conversation by following @NephJC or #NephJC on twitter, liking @NephJC on facebook, signing up for the mailing list, or just visit the webpage at NephJC.com.

On 2017 Sep 11, NephJC - Nephrology Journal Club commented:

This randomised controlled trial of oral methylprednisolone on clinical outcomes in patients With IgA nephropathy was discussed on August 29th and September 6th 2017 on #NephJC, the open online nephrology journal club. Introductory comments written by Amit Langote are available at the NephJC website here.

As one of the commoner conditions we Nephrologists face, there was lots of interest in the controversial results of this trial.

The highlights of the tweetchat were:

• There remains some uncertainty regarding the pathogenesis of IgA Nephropathy and the disease may actually comprise a spectrum of conditions. As such treatment should likely be stratified and this limits our ability to interpret RCTs of all-comers.

• It would have been useful to see renal biopsy findings determine or influence randomization procedures.

• The fact that the population were mostly Chinese may limit the generalizability of the results to western populations.

• The GFR decline was much faster than expected or previously reported but this can be the case with certain Asian populations.

• There is a general reluctance to use steroids in the absence of crescents or rapid GFR decline among Nephrologists currently and this trial further re-enforces this sentiment. We keenly await the results from the low-TESTING trial.

Transcripts of the tweetchats, and curated versions as storify will be shortly available from the NephJC website.

Interested individuals can track and join in the conversation by following @NephJC or #NephJC on twitter, liking @NephJC on facebook, signing up for the mailing list, or just visit the webpage at NephJC.com.