STEROID-THERAPY IN IGA NEPHROPATHY - A RETROSPECTIVE STUDY IN HEAVY PROTEINURIC CASES
STEROID-THERAPY IN IGA NEPHROPATHY - A RETROSPECTIVE STUDY IN HEAVY PROTEINURIC CASES
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DOI：
10.1159/000184861
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发表时间：
1988-01-01
期刊：
影响因子：
2.5
通讯作者：
KAMIYAMA, M
中科院分区：
文献类型：
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作者：
KOBAYASHI, Y;FUJII, K;KAMIYAMA, M
对29例蛋白尿持续2.0g/d以上的伊加肾病患者进行了1-3年的回顾性分析。14例肾功能不全患者中，13例患者的初始肌酐清除率（Ccr）值小于70 ml/min，随后在47个月的随访期间进入进展过程，导致8例终末期肾功能衰竭。另一方面，在74个月的随访期内，其他15例肾功能保留70 ml/min或更高的患者中仅1例最终发生终末期肾功能衰竭，尽管7例经历了进展过程。后一组中的3名患者的蛋白尿显著减少至小于1.0 g/天，并维持肾功能。同时，肌酐清除率大于70 ml/min的中度蛋白尿患者的类固醇组具有良性病程，而非类固醇组具有不利病程。这些结果表明，类固醇治疗伊加肾病可能能够稳定进展过程，特别是在疾病的早期阶段，虽然，因为他们来自一个非对照研究，不能得出明确的结论。
29 patients with IgA nephropathy whose proteinuria persisted at a level of 2.0 g/day or more and who received prednisolone treatment for 1-3 years were retrospectively evaluated on their clinical courses. 13 of 14 patients with renal dysfunction of less than 70 ml/min in initial creatinine clearance (Ccr) values subsequently entered a progressive course during a follow-up period of 47 months, leading to end-stage renal failure in 8 cases. On the other hand, only 1 of the other 15 patients with preserved renal function of 70 ml/min or more ended up with end-stage renal failure during a follow-up period of 74 months, although 7 underwent a progressive course. Three patients in the latter group experienced a prominent reduction in proteinuria to less than 1.0 g/day and maintained renal function. Meanwhile, the steroid group of moderate proteinuric patients with a creatinine clearance greater than 70 ml/min had a benign course, while the nonsteroid group had an unfavorable one. These results suggest that steroid therapy in IgA nephropathy may be able to stabilize a progressive course, especially in the early stage of the disease, although, because they come from an uncontrolled study, a definite conclusion cannot be drawn.