Corticosteroid in IgA nephropathy with moderate proteinuria : A retrospective cohort study

© 2024 Asian Pacific Society of Nephrology..

BACKGROUND: Corticosteroids remain contentious as a therapeutic option for IgA nephropathy. We conducted a retrospective cohort study to explore whether corticosteroid therapy is efficient and safe for IgAN patients with moderate proteinuria.

METHODS: A total of 336 patients with renal biopsy-confirmed IgAN, estimated glomerular filtration (eGFR) over 15 mL/min/1.73 m2 and urine protein levels of 0.75-3.5 g/d were enrolled. According to the treatment protocol, we classified the enrolled patients into two groups: one receiving corticosteroids and the other receiving supportive care. Complete remission, partial remission, and no remission were applied to describe the efficacy assessments. The endpoint was defined as a 40% reduction in eGFR, the onset of ESRD, or renal disease-related death.

RESULTS: Clinical and pathological progression risk factors were higher in corticosteroid-treated individuals. Logistic regression analysis revealed that the corticosteroid group was considerably related to a higher remission rate after adjustment for confounding factors. The occurrence of serious adverse events between the two groups was not found to be statistically significantly different. Then, we matched 95 couples of patients with similar baseline levels in both groups by propensity score matching. The results showed that corticosteroid-treated patients showed higher overall and complete remission rates than untreated patients. However, due to the relatively short follow-up period, no significant differences in the incidence of endpoint and survival analyses have been observed thus far.

CONCLUSION: Corticosteroid therapy may benefit IgAN patients with moderate proteinuria via proteinuria reduction and renal function preservation.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:29

Enthalten in:

Nephrology (Carlton, Vic.) - 29(2024), 5 vom: 22. Apr., Seite 268-277

Sprache:

Englisch

Beteiligte Personen:

Wang, Yu [VerfasserIn]
Yu, Jianwen [VerfasserIn]
Jiang, Yu [VerfasserIn]
Li, Jianbo [VerfasserIn]
Yimamuyushan, Aikeda [VerfasserIn]
Xia, Xi [VerfasserIn]
Fan, Li [VerfasserIn]
Huang, Fengxian [VerfasserIn]
Chen, Wei [VerfasserIn]
Liu, Qinghua [VerfasserIn]

Links:

Volltext

Themen:

Adrenal Cortex Hormones
Corticosteroid
Efficiency
IgA nephropathy
Journal Article
Proteinuria
RASB

Anmerkungen:

Date Completed 15.04.2024

Date Revised 23.04.2024

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1111/nep.14269

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM366766236