caa a22 4500 445882956 CHVBK 20180317145550.0 cr unu---uuuuu 170323e20110601xx s 000 0 eng 10.1007/s10157-011-0415-3 doi (NATIONALLICENCE)springer-10.1007/s10157-011-0415-3 Steroids and azathioprine in the treatment of IgA nephropathy [Elektronische Daten] [Maria Stangou, Domniki Ekonomidou, Panagiotis Giamalis, Helen Liakou, Apostolis Tsiantoulas, Afroditi Pantzaki, Aikaterini Papagianni, George Efstratiadis, Efstathios Alexopoulos, Dimitrios Memmos] Aim: IgA nephropathy (IgAN) is a very common glomerulonephritis among young adults, but the best therapeutic approach has not been fully elucidated. This study evaluated the effect of two different treatment regimes in IgAN, steroids alone or in combination with azathioprine. Methods: Among 122 patients with primary IgA nephropathy diagnosed in the 2000-2007 period, 22 fulfilled the inclusion criteria for the study: estimated glomerular filtration rate (eGRF) ≥30ml/min/1.73m2, urine protein (Upr) ≥1g/24h, blood pressure (BP) <130/80mmHg, and previous treatment with renin-angiotensin system inhibitors (RAASi) and polyunsaturated fatty acids (PFA) for at least 6months. Patients were randomized to receive either methylprednisolone alone (MP group) or MP in combination with azathioprine (MP+Aza group) for 12months, while treatment with RAASi+PFA continued unchanged in both groups. Results: At the completion of the trial, renal function in the MP group remained stable, eGFR from 52±26.7 to 53.6±27.3ml/min/1.73m2, p=NS, and Upr decreased from 2.4±0.9 to 0.8±0.5g/24h, p<0.001. In the MP+Aza group, eGFR slightly increased from 57.4±28.7 to 66±31ml/min/1.73m2, p=NS, and Upr decreased from 2.4±1 to 0.7±0.7g/24h, p<0.001. Four patients from the MP group with partial remission at the end of the trial had a complete response when converted to Aza. Eleven patients (5 from the MP and 6 from the MP+Aza group) relapsed after stopping treatment and were restarted on lower doses. Conclusions: Both, steroid treatment alone and steroids in combination with azathioprine seem to be effective in reducing the severity of proteinuria and stabilizing renal function in IgAN. Patients who do not respond to steroids may have a better response with the combination of steroids and azathioprine. Japanese Society of Nephrology, 2011 Treatment nationallicence Steroids nationallicence Azathioprine nationallicence Proteinuria nationallicence IgAN nationallicence Stangou Maria Department of Nephrology, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece aut Ekonomidou Domniki Department of Nephrology, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece aut Giamalis Panagiotis Department of Nephrology, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece aut Liakou Helen Department of Nephrology, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece aut Tsiantoulas Apostolis Department of Nephrology, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece aut Pantzaki Afroditi Department of Histopathology, Hippokration Hospital, Thessaloniki, Greece aut Papagianni Aikaterini Department of Nephrology, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece aut Efstratiadis George Department of Nephrology, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece aut Alexopoulos Efstathios Department of Nephrology, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece aut Memmos Dimitrios Department of Nephrology, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece aut Clinical and Experimental Nephrology Springer Japan 15/3(2011-06-01), 373-380 1342-1751 15:3<373 2011 15 10157 https://doi.org/10.1007/s10157-011-0415-3 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10157-011-0415-3 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Stangou Maria Department of Nephrology, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece aut NATIONALLICENCE 700 1- Ekonomidou Domniki Department of Nephrology, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece aut NATIONALLICENCE 700 1- Giamalis Panagiotis Department of Nephrology, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece aut NATIONALLICENCE 700 1- Liakou Helen Department of Nephrology, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece aut NATIONALLICENCE 700 1- Tsiantoulas Apostolis Department of Nephrology, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece aut NATIONALLICENCE 700 1- Pantzaki Afroditi Department of Histopathology, Hippokration Hospital, Thessaloniki, Greece aut NATIONALLICENCE 700 1- Papagianni Aikaterini Department of Nephrology, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece aut NATIONALLICENCE 700 1- Efstratiadis George Department of Nephrology, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece aut NATIONALLICENCE 700 1- Alexopoulos Efstathios Department of Nephrology, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece aut NATIONALLICENCE 700 1- Memmos Dimitrios Department of Nephrology, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece aut NATIONALLICENCE 773 0- Clinical and Experimental Nephrology Springer Japan 15/3(2011-06-01), 373-380 1342-1751 15:3<373 2011 15 10157 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer