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IGA nephropathy - Are intravenous steroid pulses more effective than oral steroids in relapse prevention?

2018-07Artigo científico Acesso aberto
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dc.contributor.authorLaranjinha, Ivo
dc.contributor.authorMatias, Patrícia
dc.contributor.authorCassis, João
dc.contributor.authorBranco, Patrícia
dc.contributor.authorRamos, Sância
dc.contributor.authorBarata, José Diogo
dc.contributor.authorWeigert, André
dc.contributor.institutionNOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)
dc.contributor.pblSociedad Espanola de Nefrologia; 1999
dc.date.accessioned2019-03-25T23:10:05Z
dc.date.available2019-03-25T23:10:05Z
dc.date.issued2018-07
dc.descriptionCopyright © 2017 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.
dc.description.abstractINTRODUCTION: It is recommended that IgA nephropathy (IgAN) is treated with steroids when the glomerular filtration rate (GFR) is >50ml/min and proteinuria >1g/day. Few studies have been performed comparing the two accepted steroid regimens (1g/day methylprednisolone pulses for 3 consecutive days at the beginning of months 1, 3 and 5, followed by 0.5mg/kg prednisolone on alternate days vs. 1mg/kg/day oral prednisolone). The aim of this study was to compare these two steroid regimens in IgAN treatment. METHODS: We selected 39 patients with biopsy-proven IgAN treated with steroids. Mean age at diagnosis was 37.5 years, 23 males (59%), baseline proteinuria (Uprot) was 2.1 g/day and median serum creatinine (SCr) was 1.5mg/dl. The mean follow-up period was 56 months. Twenty-five patients (64%) were treated with methylprednisolone pulses and 14 (36%) with oral steroids. RESULTS: Patients treated with steroid pulses presented lower relapse risk, defined as the reappearance of Uprot >1g/day and an Uprot increase of more than 50% (incidence rate ratio of 0.18, 95% CI 0.02-0.5). The Kaplan-Meier analysis showed longer relapse-free period (p=0.019). This result was confirmed in a multivariate analysis (p=0.026). However, we did not find other differences between the two steroid regimens. CONCLUSIONS: In comparison to oral steroids, the intravenous pulse regimen was associated with a lower risk of relapse in IgAN, a known independent negative predictor of renal survival. No differences were found regarding the other renal outcomes.en
dc.description.versionpublishersversion
dc.description.versionpublished
dc.format.extent6
dc.format.extent571163
dc.identifier.doi10.1016/j.nefro.2017.08.004
dc.identifier.issn0211-6995
dc.identifier.otherPURE: 3322240
dc.identifier.otherPURE UUID: 50f21b11-20bc-4454-8202-a310b2b8222e
dc.identifier.otherPubMed: 29129388
dc.identifier.otherWOS: 000439099700003
dc.identifier.otherScopus: 85055205516
dc.identifier.urihttp://hdl.handle.net/10362/64526
dc.language.isoeng
dc.peerreviewedyes
dc.subjectIgA nephropathy
dc.subjectSteroid regimens
dc.subjectRenal survival
dc.titleIGA nephropathy - Are intravenous steroid pulses more effective than oral steroids in relapse prevention?en
dc.typejournal article
degois.publication.firstPage355
degois.publication.issue4
degois.publication.lastPage360
degois.publication.titleNefrologia
degois.publication.volume38
dspace.entity.typePublication
rcaap.rightsopenAccess

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