Corticosteroids Improve Renal Survival: A Retrospective Analysis From Chinese Patients With Early-Stage IgA Nephropathy

Abstract

Background: The efficacy and safety of corticosteroids and immunosuppressive therapy remain controversial for the treatment of immunoglobulin A nephropathy (IgAN). This study aimed to evaluate the effects of corticosteroid and immunosuppressant therapy in Chinese patients with early-stage IgAN whose estimated glomerular filtration rate (eGFR) was ≥45 ml/min/1.73 m 2 and proteinuria was ≥1 g/24 h at biopsy. Qin et al. Corticosteroids Improve IgAN Renal Survival model showed that hypertension, serum creatinine, E1 lesion, and T1/T2 lesion remained independent predictors of poor renal survival. Conclusions: Immunosuppressive therapy does not have further benefit beyond that provided by steroids. Corticosteroids plus optimal supportive care may further be beneficial in treating early-stage IgAN patients in that it could significantly improve the short-term renal outcome.

Efficacy of prednisone combined with mycophenolate mofetil for immunoglobulin A nephropathy with moderate-to-severe renal dysfunction

“…Therefore, IgAN is currently considered a clinical syndrome that is characterized mainly by changes in renal immunopathology[ 7 ]. IgAN often progresses to ESRD, and the renal survival rates after 5 and 10 years of IgAN have been reported to be 85.1% and 77.1%, respectively, in China[ 8 ]. Approximately 15%–20% of patients with IgAN progress to ESRD 10 years after onset and 30%–40% progress to ESRD after 20 years[ 9 ].…”