New hope for kidney disease: early combo therapy may slow IgA nephropathy

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: 1. Age \>= 18 years 2. Patient with IgAN 3. Renal biopsy \< 45 days before inclusion visit 4. PCR ratio \>0.75 g/g (within 30 days before or after the renal biopsy) 5. Renal biopsy with at least 8 glomeruli, disclosing at least 2 criteria among: * mesangial proliferation (according to Oxford criteria) * endocapillary proliferation (according to Oxford criteria) * tubulointerstitial fibrosis (according to Oxford criteria) \>25% of the biopsy * segmental glomerulosclerosis (according to Oxford criteria) * at least 1 cellular/fibrocellular crescents (C1 according to Oxford criteria) 6. Patient with Social Security Insurance or CMU 7. Patient having signed an informed consent Exclusion Criteria: 1. \>30% increase of serum creatinine after starting nephroprotection therapy (≥ 15 days and ≤ 6 weeks) only for patient under nephroprotection \<45 days of the inclusion visit 2. \>50% cellular/fibrocellular crescents, or \>50% tubulointerstitial fibrosis or \>50% globally sclerotic glomeruli 3. Nephrotic syndrome with minimal change disease and IgA deposits 4. eGFR \<20 ml/min/1,73m2 (CKD-EPI formula) within 30 days before or after the renal biopsy 5. Uncontrolled blood pressure (Systolic blood pressure \>180 mmHg or diastolic blood pressure \> 110 mmHg) 6. Previous corticosteroids treatment (\>20 mg/d during more than 15 days, within the last 3 months before the renal biopsy) 7. Pregnancy or breast feeding or women without sufficient contraception 8. Secondary known forms of IgAN 9. Henoch-Schoenlein purpura 10. Additional other chronic renal disease 11. Contraindication for immunosuppressive therapy, including active intestinal bleeding, active gastric or duodenal ulcer; active infection; any malignancy in a last years before the inclusion; severe psychiatric disease; living vaccines; anti-inflammatory dosages of acetylsalicylic acid 12. Contraindication for RAS orSGLT2i blockade therapy 13. Known allergy or intolerance to corticoids or lactose 14. Organ transplant patient