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2015 ; 13
(ä): 186
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Long-term kidney survival analyses in IgA nephropathy patients under steroids
therapy: a case control study
#MMPMID26048044
Yuan Y
; Wang Q
; Ni Z
; Che X
; Cao L
; Shao X
; Zhang M
; Xie Y
; Qi C
; Zhou W
; Tian L
; Mou S
J Transl Med
2015[Jun]; 13
(ä): 186
PMID26048044
show ga
BACKGROUND: Corticosteroids are preferred to treat patients with active IgA
nephropathy (IgAN), and beneficial effects from the short-term use of
corticosteroids have been confirmed. However, a large number of patients will
progress to end-stage renal disease after a long time follow-up. This study aimed
to evaluate kidney disease progression and risk factors on kidney survival in
IgAN patients receiving steroids treatment. METHODS: Two hundred biopsy-proven
IgAN patients who received corticosteroid therapy were enrolled and followed for
a median period of 63.33 months. Risk factors on kidney survival were
retrospectively investigated by the Cox proportional hazards model. RESULTS: Of
the two hundred patients, twenty patients showed progression of renal impairment
at the end of follow-up. The median and interquartile range values for initial
serum creatinine were 89.2 and 68.08-121.35 µmol/L, respectively. Multivariate
Cox regression analyses revealed that relapse, non-remission, time-averaged eGFR
(TA-eGFR), and time-averaged serum albumin (TA-ALB) were independently associated
with the kidney progression. Those with TA-ALB levels <35 g/L and TA-eGFR levels
<60 mL/min/1.73 m(2) were less likely to recover from kidney progression.
Patients were more likely to show kidney function deterioration, when they had
non-remission or relapse after corticosteroids treatment. CONCLUSION: This study
demonstrated that relapse, non-remission, TA-eGFR, and TA-ALB could serve as
independent predictors of long term prognosis of IgAN patients receiving
corticosteroid therapy.