ACE and chronic kidney disease: There is compelling evidence that an optimized supportive treatment is the mainstay of IgAN management.[19] Lowering blood pressure to a target of systolic BP in 120 seconds has been shown to reduce CKD progression in IgAN.[19] Reaching a mean blood pressure of 129/70 mm Hg prevented the decline in kidney function over 3 years which was observed in patients achieving a mean blood pressure of 136/76 mm Hg.[20] Moreover, 2 prospective, controlled studies support the use of ACE inhibitors as first-line antihypertensive drugs in IgAN patients.[21,22]