Mon-010 Renal Disease and Obesity- An Autopsy Study

Abstract

pressure 138AE22 mm Hg, diastolic blood pressure 87AE12 mm Hg, serum creatinine 2.23AE1.85 mg/dl, serum albumin 3.7AE0.7 gm/dl and proteinuria 3.74AE2.92 gm/day. Twenty-nine (49%) received reninangiotensin-aldosterone system (RAAS) blocking agent at baseline which increased to 47 (89%) at last follow up. Forty-six (87%) received intensive immunosuppression (steroid and cyclophosphamide: 42, steroid and Mycophenolic acid: 3, steroid and azathioprine:1), 7 (13%%) received only steroid. The duration of follow up was 45.2AE33.7 months. Four (7.5%) reached the primary endpoint of doubling of serum creatinine or initiation of dialysis. The Δ systolic BP was-4.7AE26.4 mm Hg, Δ diastolic BP was-2.64AE15.1 mm Hg, ΔUP was-2.44AE2.9 gm/day, ΔSCr was-0.28AE1.97 and ΔSAlb was+0.34AE0.6 gm/ dl. Most patients tolerated immunosuppression well and there were no serious side effects when monitored closely. Conclusions: Intense immunosuppression with steroid and additional cytotoxic agent resulted in stabilization of renal function and decrease in proteinuria in most cases and progression of IgA nephropathy was seen in only 7.5% at a mean follow up period of 45 months. Our results indicate that intense immunosuppression monitored carefully may have substantial benefit in terms of retarding progression of IgA nephropathy. Strengths: Ours is one of the few studies that has analysed the effect of intense immunosuppression on the progression of IgA Nephropathy for a longer period. Limitations: Small sample size and lack of control group who did not receive immunosuppression for comparison.