TY - JOUR
T1 - Complete remission within 2 years predicts a good prognosis after methylprednisolone pulse therapy in patients with IgA nephropathy
AU - Tatematsu, Miho
AU - Yasuda, Yoshinari
AU - Morita, Yoshiki
AU - Sakamoto, Izumi
AU - Kurata, Kei
AU - Naruse, Tomohiko
AU - Yamamoto, Rhohei
AU - Tsuboi, Naotake
AU - Sato, Waichi
AU - Imai, Enyu
AU - Matsuo, Seiichi
AU - Maruyama, Shoichi
N1 - Funding Information:
This study was supported in part by a grant from the Study Group on IgA Nephropathy and by a Grant-in-Aid for Progressive Renal Diseases Research, Research on Intractable Disease, from the Ministry of Health, Labour and Welfare of Japan.
PY - 2012/12
Y1 - 2012/12
N2 - Background: Pozzi et al. reported the effectiveness of steroid pulse therapy (Pozzi's regimen) in IgA nephropathy (IgAN). The present study was performed to clarify the predictive factors for IgAN patients treated with Pozzi's regimen. Methods: One hundred nine IgAN patients treated by Pozzi's regimen were observed for up to 112.6 (median 39.7) months, and remission of proteinuria (PR) and disappearance of urinary abnormalities [complete remission (CR)] after Pozzi's regimen were analyzed. Predictive factors for the glomerular filtration rate (GFR) slopes for up to 5 years were analyzed among 81 patients who were observed for at least 2 years. The outcome of a 50 % increase in sCr was compared between the CR and non-CR groups within 2 years. Results: Cumulative PR and CR rates increased rapidly until 2 years (54.5 and 46.8 % at 2 years), and then slowly but steadily up to 6 years (72.8 and 66.4 % at 6 years). Baseline characteristics of the CR and non-CR groups within 2 years were similar except for proteinuria. GFR slope was steeper in the non-CR group than in the CR group (-2.44 ± 5.12 vs. -0.32 ± 3.34 ml/min/1.73 m 2/year). On multivariate analysis, sex and CR within 2 years were associated with GFR slope. Kaplan-Meier analysis demonstrated a better survival rate in CR group patients without a 50 % increase in sCr (p = 0.024). Conclusions: Among IgAN patients treated with Pozzi's regimen, CR within 2 years predicts a good prognosis.
AB - Background: Pozzi et al. reported the effectiveness of steroid pulse therapy (Pozzi's regimen) in IgA nephropathy (IgAN). The present study was performed to clarify the predictive factors for IgAN patients treated with Pozzi's regimen. Methods: One hundred nine IgAN patients treated by Pozzi's regimen were observed for up to 112.6 (median 39.7) months, and remission of proteinuria (PR) and disappearance of urinary abnormalities [complete remission (CR)] after Pozzi's regimen were analyzed. Predictive factors for the glomerular filtration rate (GFR) slopes for up to 5 years were analyzed among 81 patients who were observed for at least 2 years. The outcome of a 50 % increase in sCr was compared between the CR and non-CR groups within 2 years. Results: Cumulative PR and CR rates increased rapidly until 2 years (54.5 and 46.8 % at 2 years), and then slowly but steadily up to 6 years (72.8 and 66.4 % at 6 years). Baseline characteristics of the CR and non-CR groups within 2 years were similar except for proteinuria. GFR slope was steeper in the non-CR group than in the CR group (-2.44 ± 5.12 vs. -0.32 ± 3.34 ml/min/1.73 m 2/year). On multivariate analysis, sex and CR within 2 years were associated with GFR slope. Kaplan-Meier analysis demonstrated a better survival rate in CR group patients without a 50 % increase in sCr (p = 0.024). Conclusions: Among IgAN patients treated with Pozzi's regimen, CR within 2 years predicts a good prognosis.
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U2 - 10.1007/s10157-012-0644-0
DO - 10.1007/s10157-012-0644-0
M3 - Article
C2 - 22618296
AN - SCOPUS:84876291281
SN - 1342-1751
VL - 16
SP - 883
EP - 891
JO - Clinical and Experimental Nephrology
JF - Clinical and Experimental Nephrology
IS - 6
ER -