Corticosteroids in IgA Nephropathy

• DOI: 10.1681/asn.2014070697
• Publication Date: 2015-02-13T05:25:43Z
• Authors: Vladimir Tesar; Stéphan Troyanov; Shubha Bellur; Jacobien C. Verhave; H. Terence Cook; John Feehally; Ian S.D. Roberts; Daniel Cattran; Rosanna Coppo
• Keywords: Immunosuppression

Current guidelines suggest treatment with corticosteroids (CS) in IgA nephropathy (IgAN) when proteinuria is persistently ≥1 g/d despite 3–6 months of supportive care and eGFR >50 ml/min per 1.73 m2. Whether the benefits this extend to patients an eGFR≤50 m2, other levels proteinuria, or different renal pathologic lesions remains unknown. We retrospectively studied 1147 IgAN from European Validation Study Oxford Classification (VALIGA) cohort classified according Oxford-MEST classification medication used, details duration but not dosing. Overall, 46% received immunosuppression, which 98% CS. Treated individuals presented greater clinical risk factors progression. They also more antihypertensive medication, a proportion renin angiotensin system blockade (RASB) compared without immunosuppressive therapy. Immunosuppression was associated significant reduction slower rate function decline, survival. Using propensity score, we matched 184 subjects who CS RASB similar profile progression only RASB. Within group, reduced decline increased These extended those proportionally level proteinuria. Thus, regardless initial direct extent cohort.