Two year steroid therapy in progressive IgA nephropathy- -A prospective, controlled 10-year follow-up study
ASN 30th Annual Meeting, San Antonio
J Am Soc Nephrol (Sep) 8:90A 1997
This study raises the issue of steroids in IgA nephropathy - again. 109 patients were recruited over 14 yrs,between 1972 and 1986, and divided according to initial creatinine clearence and steroid therapy. The groups werre comparable in most clinical features except for proteinuria - steroid treated patients had a more severe degree of proteinuria. As it appears that the caring doctors chose to put to patients with more severe proteinuria on steroids the treatment does not appear to be randomized - a flaw in this study. The nonsteroid groups received antiplatelet drugs. Although steroid treated patients also received the antiplatelet drugs after the 2 yr course of steroids it is unclear whether the antiplatelets were given with steroids as well. The outcome data show that patients with well preserved renal function (creatinine clearence of >70 ml/min) at the time of entry into the study steroids had a significantly better outcome compared to patients with similar renal function at entry who received only the antipaltelets. Steroids did not affect the outcome in patients with clearence below 70 ml/min at the time of entry.
Comment: Although it appears that steroids may have helped the patients with intact renal function the issues of randomization raised above are of concern. It is evident that steroids are of little benefit in patients who need therapy more; i.e., those with more severe disease. (B.S. Kasinath, M.D., University of Texas at San Antonio)
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ASN 30th Annual Meeting, San Antonio
Proteinuria/Hematuria : IgA Nephropathy