Clinical and Experimental Nephrology

, Volume 16, Issue 6, pp 883–891 | Cite as

Complete remission within 2 years predicts a good prognosis after methylprednisolone pulse therapy in patients with IgA nephropathy

  • Miho Tatematsu
  • Yoshinari Yasuda
  • Yoshiki Morita
  • Izumi Sakamoto
  • Kei Kurata
  • Tomohiko Naruse
  • Rhohei Yamamoto
  • Naotake Tsuboi
  • Waichi Sato
  • Enyu Imai
  • Seiichi Matsuo
  • Shoichi Maruyama
Original Article

Abstract

Background

Pozzi et al. reported the effectiveness of steroid pulse therapy (Pozzi’s regimen) in IgA nephropathy (IgAN). The present study was performed to clarify the predictive factors for IgAN patients treated with Pozzi’s regimen.

Methods

One hundred nine IgAN patients treated by Pozzi’s regimen were observed for up to 112.6 (median 39.7) months, and remission of proteinuria (PR) and disappearance of urinary abnormalities [complete remission (CR)] after Pozzi’s regimen were analyzed. Predictive factors for the glomerular filtration rate (GFR) slopes for up to 5 years were analyzed among 81 patients who were observed for at least 2 years. The outcome of a 50 % increase in sCr was compared between the CR and non-CR groups within 2 years.

Results

Cumulative PR and CR rates increased rapidly until 2 years (54.5 and 46.8 % at 2 years), and then slowly but steadily up to 6 years (72.8 and 66.4 % at 6 years). Baseline characteristics of the CR and non-CR groups within 2 years were similar except for proteinuria. GFR slope was steeper in the non-CR group than in the CR group (−2.44 ± 5.12 vs. −0.32 ± 3.34 ml/min/1.73 m2/year). On multivariate analysis, sex and CR within 2 years were associated with GFR slope. Kaplan-Meier analysis demonstrated a better survival rate in CR group patients without a 50 % increase in sCr (p = 0.024).

Conclusions

Among IgAN patients treated with Pozzi’s regimen, CR within 2 years predicts a good prognosis.

Keywords

IgA nephropathy Immunosuppression Glomerular filtration rate Outcomes Clinical nephrology 

Notes

Acknowledgments

This study was supported in part by a grant from the Study Group on IgA Nephropathy and by a Grant-in-Aid for Progressive Renal Diseases Research, Research on Intractable Disease, from the Ministry of Health, Labour and Welfare of Japan.

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Copyright information

© Japanese Society of Nephrology 2012

Authors and Affiliations

  • Miho Tatematsu
    • 1
  • Yoshinari Yasuda
    • 1
  • Yoshiki Morita
    • 1
  • Izumi Sakamoto
    • 1
  • Kei Kurata
    • 2
  • Tomohiko Naruse
    • 3
  • Rhohei Yamamoto
    • 4
  • Naotake Tsuboi
    • 1
  • Waichi Sato
    • 1
  • Enyu Imai
    • 1
  • Seiichi Matsuo
    • 1
  • Shoichi Maruyama
    • 1
  1. 1.Department of Nephrology, Internal MedicineNagoya University Graduate School of MedicineNagoyaJapan
  2. 2.Department of Nephrology and RheumatologyTosei General HospitalAichiJapan
  3. 3.Department of NephrologyKasugai Municipal HospitalAichiJapan
  4. 4.Department of Geriatric Medicine and NephrologyOsaka University Graduate School of MedicineOsakaJapan

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