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Review sparks global kidney study

Kidney failure shortens the life of affected people, reduces quality of life and is expensive to treat. Prevention is key, as relatively few treatments have been shown to be effective.

IgA Nephropathy, where abnormal activity of the immune system causes kidney damage, is one of the most common causes of kidney failure but no specific proven treatment is currently available. Affecting mostly young adults, IgA nephropathy is the most common primary glomerular disease worldwide, and many patients develop chronic, slowly progressive kidney injury.

A new systematic review led by Dr Jicheng Lv from The George Institute, China and the Peking University First Hospital included nine trials that involved over 500 patients with IgA nephropathy. Researchers investigated the role of steroids in preventing kidney failure. The review found that steroid therapy appeared to prevent kidney failure, but at a cost of a 55% higher risk of adverse events.

According to researchers the quality of existing trials assessed in the review was suboptimal, raising concerns about the robustness of the findings. The new results, which were published in the Journal of the American Society of Nephrology call for more high quality and reliable trials to be completed among IgA nephropathy patients.

For this reason, the authors from China, Australia, India, the UK, the United States of America and Canada are planning a global study of high-risk kidney patients, called the ‘Therapeutic Evaluation of STeroids in IgA Nephropathy Global Study’ (TESTING Study). The study will include 1300 people from around the world and follow them for five years, and assess whether steroids safely prevent kidney failure.

The TESTING study will provide data that will guide the treatment of IgA nephropathy patients globally. The study will engage with patients via hospitals in China initially, and study leaders are currently working to enrol additional centres from Australia, India and other countries around the world.

The first patients were enrolled in the study from the Peking University First Hospital in May 2012. Over coming years, a large number of additional patients will participate in the TESTING study, and will provide reliable and precise evidence about the effects of this promising intervention.