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IgA nephropathy in Greece: data from the registry of the Hellenic Society of Nephrology.

ΤίτλοςIgA nephropathy in Greece: data from the registry of the Hellenic Society of Nephrology.
Publication TypeJournal Article
Year of Publication2018
AuthorsStangou, M., Papasotiriou M., Xydakis D., Oikonomaki T., Marinaki S., Zerbala S., Stylianou C., Kalliakmani P., Andrikos A., Papadaki A., Balafa O., Golfinopoulos S., Visvardis G., Moustakas G., Papachristou E., Kouloukourgiotou T., Kapsia E., Panagiotou A., Koulousios C., Kavlakoudis C., Georgopoulou M., Panagoutsos S., Vlahakos D. V., Apostolou T., Stefanidis I., Siamopoulos K., Tzanakis I., Papadogiannakis A., Daphnis E., Iatrou C., Boletis J. N., Papagianni A., & Goumenos D. S.
JournalClin Kidney J
Volume11
Issue1
Pagination38-45
Date Published2018 Feb
ISSN2048-8505
Abstract

Background: Natural history, predisposing factors to an unfavourable outcome and the effect of various therapeutic regimens were evaluated in a cohort of 457 patients with immunoglobulin A nephropathy (IgAN) and follow-up of at least 12 months.Methods: Patients with normal renal function and proteinuria <1 g/24 h as well as those with serum creatinine (SCr) >2.5 mg/dL and/or severe glomerulosclerosis received no treatment. Patients with normal or impaired renal function and proteinuria >1 g/24 h for >6 months received daily oral prednisolone or a 3-day course of intravenous (IV) methylprednisolone followed by oral prednisolone every other day or a combination of prednisolone and azathioprine. The clinical outcome was estimated using the primary endpoints of end-stage renal disease and/or doubling of baseline SCr.Results: The overall 10-year renal survival was 90.8%, while end-stage renal disease and doubling of baseline SCr developed in 9.2% and 14.7% of patients, respectively. Risk factors related to the primary endpoints were elevated baseline SCr, arterial hypertension, persistent proteinuria >0.5 g/24 h and severity of tubulointerstial fibrosis. There was no difference in the clinical outcome of patients treated by the two regimens of corticosteroids; nevertheless, remission of proteinuria was more frequent in patients who received IV methylprednisolone (P = 0.000). The combination of prednisolone with azathioprine was not superior to IV methylprednisolone followed by oral prednisolone. Side effects related to immunossuppressive drugs were observed in 12.8% of patients.Conclusion: The clinical outcome of patients with IgAN was related to the severity of clinical and histological involvement. The addition of azathioprine to a corticosteroid-based regimen for IgAN does not improve renal outcome.

DOI10.1093/ckj/sfx076
Alternate JournalClin Kidney J
PubMed ID29423199
PubMed Central IDPMC5798157

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