Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2008 Dec;23(12):3915-20.
doi: 10.1093/ndt/gfn394. Epub 2008 Jul 20.

The improvement of renal survival with steroid pulse therapy in IgA nephropathy

Ritsuko Katafuchi  1 , Toshiharu Ninomiya, Tohru Mizumasa, Kiyoshi Ikeda, Harumitsu Kumagai, Masaharu Nagata, Hideki Hirakata
Affiliations

The improvement of renal survival with steroid pulse therapy in IgA nephropathy

Ritsuko Katafuchi et al. Nephrol Dial Transplant. 2008 Dec.

Erratum in

  • Nephrol Dial Transplant. 2009 Apr;24(4):1352

Abstract

Background: The benefits of steroid therapy in immunoglobulin A nephropathy (IgAN) have not been established.

Methods: The effect of steroids on kidney survival was retrospectively investigated in 702 patients with IgAN by multivariate analyses.

Results: There were 295 men and 407 women. The median follow-up period was 62 months. One hundred and ninety-four patients were treated with oral steroids (oral steroid group). Thirty-four patients were treated with methylprednisolone (mPSL) pulse therapy (pulse steroid group) followed by oral prednisolone (PSL). In 474 patients, no steroid was used (no steroid group). The urinary protein-creatinine ratio and histological grade were significantly different among treatment groups and were highest in the pulse steroid group followed by the oral steroid group and lowest in the no steroid patients. Serum creatinine was significantly higher in the pulse steroid group than in other two groups. Eighty-five patients developed end-stage renal failure (ESRF) requiring dialysis. [corrected] In multivariate analysis, steroid pulse therapy significantly decreased the risk of ESRF while oral steroid treatment did not improve renal survival in this cohort.

Conclusion: We found that pulse steroid therapy improved kidney survivals in IgAN. Since the clinical findings and histological grade were the most severe in patients treated with mPSL pulse therapy, such therapy may prevent progression of IgAN.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Kidney survival curve in each histological grade. The patients with histological grades I and II were analysed together due to the small number of end-stage renal failure incidence. Kidney survivals significantly differed among the histological grades (P < 0.0001). The numbers of patients remaining at 60, 120 and 180 months of follow-up in each histological grade are shown at the bottom.
See this image and copyright information in PMC

References

    1. Kobayashi Y, Fujii K, Hiki Y, et al. Steroid therapy in IgA nephropathy: a prospective pilot study in moderate proteinuric cases. Q J Med. 1986;61:935–943. - PubMed
    1. Kobayashi Y, Fujii K, Hiki Y, et al. Steroid therapy in IgA nephropathy: a retrospective study in heavy proteinuric cases. Nephron. 1988;48:12–17. - PubMed
    1. Kobayashi Y, Hiki Y, Fujii K, et al. Moderately proteinuric IgA nephropathy: prognostic prediction of individual clinical courses and steroid therapy in progressive cases. Nephron. 1989;53:250–256. - PubMed
    1. Waldo FB, Alexander R, Wyatt RJ, et al. Alternate-day prednisone therapy in children with IgA-associated nephritis. Am J Kidney Dis. 1989;13:55–60. - PubMed
    1. Andreoli SP, Bergstein JM. Treatment of severe IgA nephropathy in children. Pediatr Nephrol. 1989;3:248–253. - PubMed

MeSH terms