Cellular Crescents and Segmental Glomerular Necrosis in IgA Nephropathy Are Indicative of the Beneficial Effects of Corticosteroid Therapy.

Tomiyoshi, Yoshiyuki; Sakemi, Takanobu; Ikeda, Yuji; Ohtsuka, Yoko; Nakamura, Megumi; Fujisaki, Taisei

doi:10.2169/internalmedicine.40.862

Cited by 17 publications

(8 citation statements)

References 11 publications

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“…They suggested that steroid therapy could delay the progression to endstage renal failure (ESRD). Tomiyoshi et al 10 also suggested that steroid therapy was effective for IgAN patients who showed a high percentage of cellular and fibrocellular crescents, although the Ccr in their patients was under 70 ml/min.…”

Section: Discussionmentioning

confidence: 97%

The effectiveness of steroid therapy for patients with advanced IgA nephropathy and impaired renal function

et al. 2004

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In the present study, in advanced IgAN patients whose creatinine clearance was under 70 ml/min, steroid therapy effectively reduced the amount of proteinuria and maintained the serum creatinine level, if the treatment was selectively applied to patients with a moderate amount of proteinuria and active glomerular lesions such as cellular and fibrocellular crescents, and mesangial cell proliferation.

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Section: Discussionmentioning

confidence: 97%

The effectiveness of steroid therapy for patients with advanced IgA nephropathy and impaired renal function

et al. 2004

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“…The pathological features have been proved as risk factors for progression of IgAN and were important factors for guiding treatment [5,6,21,22] . Most of the research found SGN accompanied by crescents were indicative of the beneficial effects of corticosteroid therapy [13][14][15] . In D'Amico's research, about IgAN with SGN, the effect of corticosteroid was not defined [21] .…”

Section: Discussionmentioning

confidence: 99%

“…But the significance of SGN was not included in all the classifications. Most of the researches about SGN in IgAN were about cellular crescents accompanied with SGN [13][14][15] . However, we have observed a number of patients who have presented with slight histopathological damage despite SGN.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of IgA Nephropathy with Segmental Glomerular Necrosis But without Crescent Formation

Tan

Li²,

Zou³

et al. 2016

Am J Nephrol

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Background: The significance of segmental glomerular necrosis (SGN) was not evident in immunoglobulin A nephropathy (IgAN) patients. Especially, there were a number of patients who presented with slight histopathological damage except SGN. We, therefore, conducted a study to highlight the occurrence of these cases and to define their clinical characteristics and outcomes at our centre. Methods: The clinical, laboratory and pathological manifestations and outcomes of these IgAN patients were collected and compared with IgAN patients with simily histopathological background but without SGN. Survival curves were constructed according to the Kaplan-Meier method. Multivariate Cox regression analysis was used to identify independent factors for the development of endpoint. Results: Eighty-two patients with SGN but without crescents were found in Haas grades I-III. Macroscopic hematuria and prodromal infection were more popular and the mean daily proteinuria was significantly higher in patients with SGN. More patients had high serum IgA in the ecrotizing IgAN group. At last follow-up, there were no differences in hypertension, proteinuria, serum creatinine, estimated GFR and the incidence of end-point events between 2 groups. SGN was not an independent predictor for the prognosis of IgAN. Corticosteroid treatment could decrease proteinuria significantly. The outcomes of the 2 populations of necrotizing IgAN patients with or without corticosteroid treatment were not different. Conclusions: SGN can be found in mild pathological damage patients and is not always associated with crescent formation. Heavier proteinuria was found in these IgAN patients. SGN was not an independent predictor for the prognosis of IgAN.

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“…They suggested that steroid therapy could delay the progression to end-stage renal failure. Tomiyoshi et al [15] suggested that steroid therapy (40-50 mg/day as an initial dose) was effective for IgAN patients who showed a high percentage of cellular and fibrocellular crescents and/or segmental glomerular sclerosis, although their Ccr was under 70 ml/min. We also reported the effectiveness of steroid therapy for advanced IgAN patients with reduced renal function [16].…”

Section: Discussionmentioning

confidence: 99%

Clinical assessment of low-dose steroid therapy for patients with IgA nephropathy: a prospective study in a single center

et al. 2008

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Cellular Crescents and Segmental Glomerular Necrosis in IgA Nephropathy Are Indicative of the Beneficial Effects of Corticosteroid Therapy.

Cited by 17 publications

References 11 publications

The effectiveness of steroid therapy for patients with advanced IgA nephropathy and impaired renal function

The effectiveness of steroid therapy for patients with advanced IgA nephropathy and impaired renal function

Outcomes of IgA Nephropathy with Segmental Glomerular Necrosis But without Crescent Formation

Clinical assessment of low-dose steroid therapy for patients with IgA nephropathy: a prospective study in a single center

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