1. Treatment protocol with pulse and oral steroids for IgA Nephropathy after kidney transplantation.
- Author
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Messina M, di Vico MC, Ariaudo C, Mazzucco G, Fop F, Segoloni GP, and Biancone L
- Subjects
- Administration, Intravenous, Administration, Oral, Adult, Clinical Protocols, Creatinine blood, Female, Follow-Up Studies, Glomerulonephritis, IGA etiology, Humans, Immunosuppression Therapy methods, Male, Middle Aged, Proteinuria drug therapy, Retrospective Studies, Treatment Outcome, Glomerulonephritis, IGA drug therapy, Glucocorticoids administration & dosage, Kidney Transplantation adverse effects, Methylprednisolone administration & dosage, Prednisone administration & dosage
- Abstract
Background: No specific treatment for IgA nephropathy (IgAN) after kidney transplantation is currently available., Methods: We conducted a retrospective single-center study on 29 patients with biopsy-proven de novo and recurrent IgAN after kidney transplantation, divided into two groups. Group 1 (n = 16) received intravenous methylprednisolone 500 mg per day for three consecutive days at the beginning of months 1, 3 and 5, plus oral prednisone 0.5 mg/kg every other day for 6 months. The control group (n = 13, Group 2) received supportive therapies., Results: The two groups were comparable for serum creatinine (sCr) and proteinuria at the time of renal biopsy, but differed significantly at the end of follow-up. sCr was 1.8 ± 0.4 mg/dl in Group 1 vs. 2.7 ± 0.9 in Group 2 (p = 0.002), and proteinuria was 0.9 g/day in Group 1 vs. 1.9 in Group 2 (p = 0.04). The composite outcome of death-censored graft loss or doubling of sCr displayed 2 events in Group 1 (12.5 % of the entire group) and 5 events in Group 2 (38.5 % of the entire group), p = 0.19, odds ratio (OR) 4.4 [95 % confidence interval (CI) 0.7-27.8]., Conclusions: In the absence of therapeutic guidelines for de novo or recurrent IgAN after kidney transplantation, our study reports that therapy with pulse and oral steroids for 6 months is associated with an improved renal function. Nevertheless, further randomized controlled studies in larger patient cohorts are necessary to establish the gold standard treatment.
- Published
- 2016
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