In the present issue of AJKD, Liu et al1 from China report a single-center, randomized, controlled, double-blind trial in patients with primary immunoglobulin A nephropathy (IgAN). Patients had to exhibit an estimated glomerular filtration rate (eGFR)>30mL/min/1.73m2 and proteinuria with protein excretion between 0.75 and 3.5g/d despite maximum tolerated renin-angiotensin-aldosterone system (RAAS) inhibitor therapy for at least 3 months to be included in the study. At a mean eGFR of 54mL/min/1.73m2 and median proteinuria with protein excretion of 1.7g/d, the 60 patients included certainly were at high risk for progressive IgAN.