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. 2022 Aug 4;7(10):2160-2165.
doi: 10.1016/j.ekir.2022.07.163. eCollection 2022 Oct.

Efficacy of Corticosteroids in Infection-Related Glomerulonephritis-A Randomized Controlled Trial

Srinivasan Arivazhagan  1 , Tanuj Moses Lamech  1 , Murugan Myvizhiselvi  1 , Venkatesh Arumugam  1 , Sheik Sulthan Alavudeen  1 , Shivakumar Dakshinamoorthy  1 , Thanigachalam Dineshkumar  1 , Ramanathan Sakthirajan  1 , Jeyachandran Dhanapriya  1 , Palaniselvam Shankar  1 , Rajendran Padmaraj  1 , Anila Abraham Kurien  2 , Natarajan Gopalakrishnan  1
Affiliations

Efficacy of Corticosteroids in Infection-Related Glomerulonephritis-A Randomized Controlled Trial

Srinivasan Arivazhagan et al. Kidney Int Rep. .

Abstract

Introduction: Infection-related glomerulonephritis (IRGN) is associated with glomerular immune complex deposition along with complement activation. Steroids may attenuate glomerular injury and thereby improve renal outcomes.

Methods: We randomly assigned patients who had biopsy-proven IRGN and serum creatinine greater than 1.5 mg/dl to receive corticosteroids plus supportive care (intervention arm), or supportive care alone (control arm). Patients were followed up for 6 months. The primary outcome was complete renal recovery at 6 months. Safety of steroid therapy was also assessed.

Results: A total of 52 patients underwent randomization. At 6 months, 17 of 26 patients (65.4%) in the intervention arm and 14 of 26 patients (53.8%) in the control arm had complete renal recovery (odds ratio 1.6; 95% confidence interval, 0.5-4.9; P = 0.397). There was no statistically significant difference in any of the secondary outcomes. Adverse events occurred in 12 patients (46.2%) in the intervention arm and 2 patients (7.7%) in the control arm (P = 0.002).

Conclusion: In this single-center trial, corticosteroids did not result in a statistically significant increase in rates of complete renal recovery at 6 months. There was a significantly increased risk of adverse events associated with the use of corticosteroids.

Keywords: IRGN; infection-related glomerulonephritis; steroids.

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Figures

None
Graphical abstract
Figure 1
Figure 1
Description of participant flow in the trial. IRGN, infection-related glomerulonephritis; RPS, Renal Pathology Society.
See this image and copyright information in PMC

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