Effectiveness of treatment with glucocorticosteroids in immunoglobulin A nephropathy with active proliferative histopatological changes

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Objective. Evaluation of the effectiveness of glucocorticosteroid (GCS) treatment in patients with immunoglobulin A nephropathy (IgAN) and the presence of histopathological proliferative changes according to the Oxford classification (MEST-C).

Material and methods. The effectiveness of therapy after 6 months of treatment in 2 groups of patients with IgAN and the presence of histopathological proliferative changes (M1, E1 and/or C1) with glomerular filtration rate >50 ml/min and proteinuria >0.75 g/day (group 1 - ACE inhibitors or ARBs (n=21), group 2 - corticosteroids (n=15)) was evaluated.

Results. Clinical and laboratory parameters improved in both treatment groups, but the overall remission rate in the group 1 was 33%, which was significantly lower compare to the group 2 - 87% (P = 0.023). Patients treated with ACE inhibitors or ARBs had a high incidence of IgAN progression after 6 months of treatment compared with patients treated with corticosteroids (P = 0.001).

Conclusion. Early use of corticosteroids in patients with IgAN and the presence of histopathological proliferative changes provides a significant increase in the incidence of clinical and laboratory remission by 53.4% (P=0.002) without side effects.

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作者简介

Kirill Komissarov

Minsk Scientific and Practical Center for Surgery, Transplantology and Hematology; Belarusian Medical Academy of Postgraduate Education

编辑信件的主要联系方式.
Email: kirill_ka@tut.by
ORCID iD: 0000-0002-2648-0642

Cand. Sci.(Med.), Associate Professor, Head of the Department of Nephrology, Renal Replacement Therapy and Kidney Transplantation, Minsk Scientific and Practical Center for Surgery, Transplantology and Hematology

白俄罗斯, Minsk; Minsk

Olga Krasko

Joint Institute for Informatics Problems of the National Academy of Sciences of Belarus

Email: olga.krasko.ok@gmail.com
ORCID iD: 0000-0002-4150-282X

Cand. Sci.(Med.), Address: 6 Surganov st., Minsk

白俄罗斯, Minsk

Elena Minchenko

1st City Clinical Hospital

Email: elena_nefro@mail.ru
ORCID iD: 0000-0001-6268-7563

Nephrologist, Department of Nephrology, 1st City Clinical Hospital

白俄罗斯, Minsk

Valery Pilotovich

Belarusian Medical Academy of Postgraduate Education

Email: pilotovich@mail.ru
ORCID iD: 0000-0001-8256-5889

Dr. Sci. (Med.), Professor at the Department of Urology and Nephrology, Medical Academy of Postgraduate Education

白俄罗斯, Minsk

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2. Fig. 1. Scheme of study design and patient selection

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3. Fig. 2. Dynamics of laboratory parameters in patients with IgAN after 6 months, taking into account the ongoing treatment

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