Jonathan Barratt, PhD, FRCP: Carla, I'm often fascinated by children because to me they're completely different levels. And I'd be interested in your experience of how IgA nephropathy presents and differs or is the same in fact between adults and children?

Carla M. Nester, MD, MSA, FASN: Well, in fact, I could say it's very similar to what Dr Appel has presented in that there can be asymptomatic children but there can also be children with very aggressive disease. And the problem is, determining who that's going to be and whether supportive care is going to support them long enough. Let's face it. Children have double, quadruple many, many more years of native kidney disease that we have to try to achieve success with, and it's just very difficult to find that right now. They do present with infection like we already mentioned. What do you do with them? How aggressive can you be with them? Right now, we just don't have the therapies to be aggressive with them. It's an important direction for us to be considering our next step in research, frankly.

Jonathan Barratt, PhD, FRCP: Absolutely. And with all the new therapies that are currently being evaluated in adults, it will be lovely to see those translated through to pediatric practice.

Transcript Edited for Clarity