Predictors of poor outcomes in steroid therapy for immunoglobulin A nephropathy
| العنوان: | Predictors of poor outcomes in steroid therapy for immunoglobulin A nephropathy |
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| المؤلفون: | Ari Shimizu, Keiko Uchida, Ken Tsuchiya, Takashi Takei, Kosaku Nitta |
| المصدر: | Nephrology. 14:521-526 |
| بيانات النشر: | Wiley, 2009. |
| سنة النشر: | 2009 |
| مصطلحات موضوعية: | Adult, Male, medicine.medical_specialty, Adolescent, medicine.medical_treatment, Serum albumin, Renal function, urologic and male genital diseases, Gastroenterology, Steroid, Excretion, Adrenal Cortex Hormones, Internal medicine, medicine, Humans, Pathological, Proteinuria, medicine.diagnostic_test, biology, urogenital system, business.industry, Glomerulonephritis, IGA, Glomerulonephritis, General Medicine, Middle Aged, medicine.disease, female genital diseases and pregnancy complications, Treatment Outcome, Endocrinology, Nephrology, Creatinine, biology.protein, Female, Renal biopsy, medicine.symptom, business, Glomerular Filtration Rate |
| الوصف: | SUMMARY Background: Steroid therapy appears to be beneficial in patients of immunoglobulin A nephropathy (IgAN), as it causes a reduction in the proteinuria and improves the renal survival. Methods: A retrospective review of the 5 year follow-up data of 60 patients with IgAN who were treated with steroids was conducted. Steroid non-responders were defined as patients in whom the primary end-point of a 30% decrease of the estimated glomerular filtration rate from baseline was reached. The patients were divided into two groups, namely, the steroid responder group (n = 47) and the steroid non-responder group (n = 13), and the clinicopathophysiological characteristics were compared between the two groups. Results: Significant decrease of the proteinuria was observed in the responder group over the 5 year follow-up period, whereas no significant change of the urinary protein excretion was observed in the non-responder group during the same period. In regard to the pathological findings, significantly higher ratios of glomerular obsolescence and glomerular tuft adhesion to the Bowman's capsule, and significantly higher severity of interstitial fibrosis at the time of diagnosis in the non-responder group than in the responder group were found. The rates of glomerular obsolescence and glomerular tuft adhesion to the Bowman's capsule, the severity of interstitial fibrosis, serum albumin and urinary protein excretion were identified as independent risk factors influencing the rate of renal function deterioration. Conclusion: To develop effective therapeutic modalities, it is important to have a thorough understanding of the clinicopathophysiological characteristics of IgAN patients showing poor treatment response to steroids (non-responder group in this study). |
| تدمد: | 1440-1797 1320-5358 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::0b104bea450f96f5cb4f78ae70a960a2 https://doi.org/10.1111/j.1440-1797.2009.01104.x |
| حقوق: | CLOSED |
| رقم الأكسشن: | edsair.doi.dedup.....0b104bea450f96f5cb4f78ae70a960a2 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14401797 13205358 |
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