Role of corticosteroid therapy in IgA nephropathy; where do we stand?

Shankar Prasad Nagaraju, Sindhura Lakshmi Koulmane Laxminarayana, Aswani Srinivas Mareddy, Srikanth Prasad, Sindhu Kaza, Srinivas Shenoy, Karan Saraf, Dharshan Rangaswamy, Ravindra Prabhu Attur, Rajeevalochana Parthasarathy, Uday Venkat Mateti, Vasudeva Guddattu, Mahesha Vankalakunti

Research output: Contribution to journalArticle

Abstract

Background: Current KDIGO guidelines suggest corticosteroids (CS) administration in IgA nephropathy (IgAN) with persistent proteinuria >1 g/d despite 3-6 months of supportive care and estimated glomerular filtration rate (eGFR) >50 mL/min/1.73 m2. The benefits of CS in patients with eGFR <50 mL/min/1.73 m2 is unclear. Objectives: To assess the effect of steroids on disease progression and proteinuria in IgAN patients with eGFR < 50 mL/min/ 1.73m2 compared with >50 mL/min/1.73 m2. Patients and Methods: A cohort of biopsy proven primary IgAN diagnosed between March 2010 - February 2015 who received oral CS with minimum follow-up of 6 months were included. They were categorized into two groups according to their eGFR (group 1 -eGFR <50 mL/min/1.73 m2, group 2 - eGFR >50 mL/min/1.73 m2). The eGFR and urine protein creatinine ratio (UPCR) were followed up at entry, 6 months, 12 months and at the end of follow-up. Outcomes studied were change in eGFR, proteinuria and progression to end-stage renal disease (ESRD). Results: Out of 44 patients, 23 were in group1 and 21 patients in group 2. At the end of follow-up, similar reduction of proteinuria (UPCR) was observed in both groups (P = 0.62). However, group 1 had a significant fall in eGFR compared to improvement in group 2 (P = 0.004). One in each group has reached CKD stage 5 (P = 0.73). Conclusions: Addition of CS to conservative treatment in IgAN patients with initial eGFR<50 ml/min/1.73 m2 seems to reduce proteinuria but not beneficial in preventing progression of disease as compared to patients with higher eGFR (>50 mL/min/1.73 m2).

Original languageEnglish
Pages (from-to)368-373
Number of pages6
JournalJournal of Nephropathology
Volume6
Issue number4
DOIs
Publication statusPublished - 01-01-2017

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Glomerular Filtration Rate
Immunoglobulin A
Adrenal Cortex Hormones
Proteinuria
Therapeutics
Creatinine
Urine
Chronic Kidney Failure
Proteins
Guidelines
Biopsy

All Science Journal Classification (ASJC) codes

  • Nephrology

Cite this

Nagaraju, S. P., Laxminarayana, S. L. K., Mareddy, A. S., Prasad, S., Kaza, S., Shenoy, S., ... Vankalakunti, M. (2017). Role of corticosteroid therapy in IgA nephropathy; where do we stand? Journal of Nephropathology, 6(4), 368-373. https://doi.org/10.15171/jnp.2017.61
Nagaraju, Shankar Prasad ; Laxminarayana, Sindhura Lakshmi Koulmane ; Mareddy, Aswani Srinivas ; Prasad, Srikanth ; Kaza, Sindhu ; Shenoy, Srinivas ; Saraf, Karan ; Rangaswamy, Dharshan ; Attur, Ravindra Prabhu ; Parthasarathy, Rajeevalochana ; Mateti, Uday Venkat ; Guddattu, Vasudeva ; Vankalakunti, Mahesha. / Role of corticosteroid therapy in IgA nephropathy; where do we stand?. In: Journal of Nephropathology. 2017 ; Vol. 6, No. 4. pp. 368-373.
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abstract = "Background: Current KDIGO guidelines suggest corticosteroids (CS) administration in IgA nephropathy (IgAN) with persistent proteinuria >1 g/d despite 3-6 months of supportive care and estimated glomerular filtration rate (eGFR) >50 mL/min/1.73 m2. The benefits of CS in patients with eGFR <50 mL/min/1.73 m2 is unclear. Objectives: To assess the effect of steroids on disease progression and proteinuria in IgAN patients with eGFR < 50 mL/min/ 1.73m2 compared with >50 mL/min/1.73 m2. Patients and Methods: A cohort of biopsy proven primary IgAN diagnosed between March 2010 - February 2015 who received oral CS with minimum follow-up of 6 months were included. They were categorized into two groups according to their eGFR (group 1 -eGFR <50 mL/min/1.73 m2, group 2 - eGFR >50 mL/min/1.73 m2). The eGFR and urine protein creatinine ratio (UPCR) were followed up at entry, 6 months, 12 months and at the end of follow-up. Outcomes studied were change in eGFR, proteinuria and progression to end-stage renal disease (ESRD). Results: Out of 44 patients, 23 were in group1 and 21 patients in group 2. At the end of follow-up, similar reduction of proteinuria (UPCR) was observed in both groups (P = 0.62). However, group 1 had a significant fall in eGFR compared to improvement in group 2 (P = 0.004). One in each group has reached CKD stage 5 (P = 0.73). Conclusions: Addition of CS to conservative treatment in IgAN patients with initial eGFR<50 ml/min/1.73 m2 seems to reduce proteinuria but not beneficial in preventing progression of disease as compared to patients with higher eGFR (>50 mL/min/1.73 m2).",
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Nagaraju, SP, Laxminarayana, SLK, Mareddy, AS, Prasad, S, Kaza, S, Shenoy, S, Saraf, K, Rangaswamy, D, Attur, RP, Parthasarathy, R, Mateti, UV, Guddattu, V & Vankalakunti, M 2017, 'Role of corticosteroid therapy in IgA nephropathy; where do we stand?', Journal of Nephropathology, vol. 6, no. 4, pp. 368-373. https://doi.org/10.15171/jnp.2017.61

Role of corticosteroid therapy in IgA nephropathy; where do we stand? / Nagaraju, Shankar Prasad; Laxminarayana, Sindhura Lakshmi Koulmane; Mareddy, Aswani Srinivas; Prasad, Srikanth; Kaza, Sindhu; Shenoy, Srinivas; Saraf, Karan; Rangaswamy, Dharshan; Attur, Ravindra Prabhu; Parthasarathy, Rajeevalochana; Mateti, Uday Venkat; Guddattu, Vasudeva; Vankalakunti, Mahesha.

In: Journal of Nephropathology, Vol. 6, No. 4, 01.01.2017, p. 368-373.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Role of corticosteroid therapy in IgA nephropathy; where do we stand?

AU - Nagaraju, Shankar Prasad

AU - Laxminarayana, Sindhura Lakshmi Koulmane

AU - Mareddy, Aswani Srinivas

AU - Prasad, Srikanth

AU - Kaza, Sindhu

AU - Shenoy, Srinivas

AU - Saraf, Karan

AU - Rangaswamy, Dharshan

AU - Attur, Ravindra Prabhu

AU - Parthasarathy, Rajeevalochana

AU - Mateti, Uday Venkat

AU - Guddattu, Vasudeva

AU - Vankalakunti, Mahesha

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Background: Current KDIGO guidelines suggest corticosteroids (CS) administration in IgA nephropathy (IgAN) with persistent proteinuria >1 g/d despite 3-6 months of supportive care and estimated glomerular filtration rate (eGFR) >50 mL/min/1.73 m2. The benefits of CS in patients with eGFR <50 mL/min/1.73 m2 is unclear. Objectives: To assess the effect of steroids on disease progression and proteinuria in IgAN patients with eGFR < 50 mL/min/ 1.73m2 compared with >50 mL/min/1.73 m2. Patients and Methods: A cohort of biopsy proven primary IgAN diagnosed between March 2010 - February 2015 who received oral CS with minimum follow-up of 6 months were included. They were categorized into two groups according to their eGFR (group 1 -eGFR <50 mL/min/1.73 m2, group 2 - eGFR >50 mL/min/1.73 m2). The eGFR and urine protein creatinine ratio (UPCR) were followed up at entry, 6 months, 12 months and at the end of follow-up. Outcomes studied were change in eGFR, proteinuria and progression to end-stage renal disease (ESRD). Results: Out of 44 patients, 23 were in group1 and 21 patients in group 2. At the end of follow-up, similar reduction of proteinuria (UPCR) was observed in both groups (P = 0.62). However, group 1 had a significant fall in eGFR compared to improvement in group 2 (P = 0.004). One in each group has reached CKD stage 5 (P = 0.73). Conclusions: Addition of CS to conservative treatment in IgAN patients with initial eGFR<50 ml/min/1.73 m2 seems to reduce proteinuria but not beneficial in preventing progression of disease as compared to patients with higher eGFR (>50 mL/min/1.73 m2).

AB - Background: Current KDIGO guidelines suggest corticosteroids (CS) administration in IgA nephropathy (IgAN) with persistent proteinuria >1 g/d despite 3-6 months of supportive care and estimated glomerular filtration rate (eGFR) >50 mL/min/1.73 m2. The benefits of CS in patients with eGFR <50 mL/min/1.73 m2 is unclear. Objectives: To assess the effect of steroids on disease progression and proteinuria in IgAN patients with eGFR < 50 mL/min/ 1.73m2 compared with >50 mL/min/1.73 m2. Patients and Methods: A cohort of biopsy proven primary IgAN diagnosed between March 2010 - February 2015 who received oral CS with minimum follow-up of 6 months were included. They were categorized into two groups according to their eGFR (group 1 -eGFR <50 mL/min/1.73 m2, group 2 - eGFR >50 mL/min/1.73 m2). The eGFR and urine protein creatinine ratio (UPCR) were followed up at entry, 6 months, 12 months and at the end of follow-up. Outcomes studied were change in eGFR, proteinuria and progression to end-stage renal disease (ESRD). Results: Out of 44 patients, 23 were in group1 and 21 patients in group 2. At the end of follow-up, similar reduction of proteinuria (UPCR) was observed in both groups (P = 0.62). However, group 1 had a significant fall in eGFR compared to improvement in group 2 (P = 0.004). One in each group has reached CKD stage 5 (P = 0.73). Conclusions: Addition of CS to conservative treatment in IgAN patients with initial eGFR<50 ml/min/1.73 m2 seems to reduce proteinuria but not beneficial in preventing progression of disease as compared to patients with higher eGFR (>50 mL/min/1.73 m2).

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Nagaraju SP, Laxminarayana SLK, Mareddy AS, Prasad S, Kaza S, Shenoy S et al. Role of corticosteroid therapy in IgA nephropathy; where do we stand? Journal of Nephropathology. 2017 Jan 1;6(4):368-373. https://doi.org/10.15171/jnp.2017.61