| Autor: |
Stangou, 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. |
| Jazyk: |
angličtina |
| Rok vydání: |
2018 |
| Předmět: |
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| Popis: |
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 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 per os 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 ¼ 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. © The Author 2017. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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