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
. 2024 Dec;46(1):2341787.
doi: 10.1080/0886022X.2024.2341787. Epub 2024 Apr 18.

Immunosuppressive treatment results in patients with primary IgA nephropathy in Turkiye; the data from TSN-GOLD working group

Aysegul Oruc  1 , Abdullah Sumnu  2 , Aydın Turkmen  3 , Taner Basturk  4 , Egemen Cebeci  5 , Kenan Turgutalp  6 , Hakkı Cetinkaya  7 , Müge Uzerk Kibar  8 , Nurhan Seyahi  9 , Erhan Tatar  10 , Metin Ergul  11 , Ülver Derici  12 , Mehmet Deniz Aylı  13 , Musa Pınar  14 , Betül Bakar  15 , Rümeyza Kazancıoglu  16 , Abdülmecit Yıldız  1 , Ahmet Burak Dirim  17 , Zülfükar Yılmaz  18 , Kültigin Turkmen  19 , Onur Tunca  20 , Mehmet Koc  21 , Sim Kutlay  22 , Hasan Micozkadıoglu  23 , Alper Azak  24 , Burcu Boztepe  25 , Sedat Ustundag  26 , Seda Şafak Ozturk  3 , Abdulkadir Unsal  4 , Serhat Karadag  5 , Gülizar Sahin  7 , Ezgi Coşgun Yenigun  15 , Necmi Eren  11 , Mustafa Gullulu  1 , Meltem Gursu  16 , Savaş Ozturk  3
Affiliations

Immunosuppressive treatment results in patients with primary IgA nephropathy in Turkiye; the data from TSN-GOLD working group

Aysegul Oruc et al. Ren Fail. 2024 Dec.

Abstract

Background: Immunoglobulin A (IgA) nephropathy (IgAN) treatment consists of maximal supportive care and, for high-risk individuals, immunosuppressive treatment (IST). There are conflicting results regarding IST. Therefore, we aimed to investigate IST results among IgAN patients in Turkiye.

Method: The data of 1656 IgAN patients in the Primary Glomerular Diseases Study of the Turkish Society of Nephrology Glomerular Diseases Study Group were analyzed. A total of 408 primary IgAN patients treated with IST (65.4% male, mean age 38.4 ± 12.5 years, follow-up 30 (3-218) months) were included and divided into two groups according to treatment protocols (isolated corticosteroid [CS] 70.6% and combined IST 29.4%). Treatment responses, associated factors were analyzed.

Results: Remission (66.7% partial, 33.7% complete) was achieved in 74.7% of patients. Baseline systolic blood pressure, mean arterial pressure, and proteinuria levels were lower in responsives. Remission was achieved at significantly higher rates in the CS group (78% vs. 66.7%, p = 0.016). Partial remission was the prominent remission type. The remission rate was significantly higher among patients with segmental sclerosis compared to those without (60.4% vs. 49%, p = 0.047). In the multivariate analysis, MEST-C S1 (HR 1.43, 95% CI 1.08-1.89, p = 0.013), MEST-C T1 (HR 0.68, 95% CI 0.51-0.91, p = 0.008) and combined IST (HR 0.66, 95% CI 0.49-0.91, p = 0.009) were found to be significant regarding remission.

Conclusion: CS can significantly improve remission in high-risk Turkish IgAN patients, despite the reliance on non-quantitative endpoints for favorable renal outcomes. Key predictors of remission include baseline proteinuria and specific histological markers. It is crucial to carefully weigh the risks and benefits of immunosuppressive therapy for these patients.

Keywords: IgA nephropathy; Turkiye; immunosuppressive treatment; outcome; remission.

PubMed Disclaimer

Conflict of interest statement

The authors report there are no competing interests to declare.

Figures

Figure 1.
Figure 1.
Study Flowchart.
Figure 2.
Figure 2.
Remission rates of other immunosuppressive protocols. CS: corticosteroid, CYS: cyclophosphamide, MMF: mycophenolate mofetil, CNI: calcineurin inhibitor, AZA: azathioprine.
Figure 3.
Figure 3.
Cumulative incidence of primary outcome, remission, according to remission-associated risk factors during follow-ups. CI: Confidence Interval.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Turkmen A, Sumnu A, Cebeci E, et al. . Epidemiological features of primary glomerular disease in turkiye: a multicenter study by the Turkish society of nephrology glomerular diseases working group. BMC Nephrol. 2020;21(1):1. - PMC - PubMed
    1. Wyatt RJ, Julian BA.. IgA nephropathy. N Engl J Med. 2013;368(25):2402–10. - PubMed
    1. Coppo R, D’Amico G.. Factors predicting progression of IgA nephropathies. J Nephrol. 2005;18(5):503–512. - PubMed
    1. Kidney Disease: Improving Global Outcomes (KDIGO) Glomerular Diseases Work Group . KDIGO 2021 clinical practice guideline for the management of glomerular diseases. Kidney Int. 2021;100(4S):S1–S276. - PubMed
    1. Zhang YM, Lv JC, Wong MG, Zhang H, Perkovic V.. Glucocorticoids for IgA nephropathy-pro. Kidney Int. 2023;103(4):666–669. - PubMed

Substances