Steroid therapy reduces mesangial matrix accumulation in advanced IgA nephropathy.

Abstract

BACKGROUND:

Steroid therapy for IgA nephropathy (IgAN) has been reported to ameliorate the long-term prognosis of IgAN, but its mode of action has not been fully elucidated. In this study, we examined the effect of steroids on glomerular morphological changes in IgAN.

METHODS:

We examined 16 patients with biopsy-proven IgAN (male/female =11/5, mean age 32.1 years) who were divided into prognosis groups according to criteria set by the Japanese Society of Nephrology. Initially, they received a loading dose of steroids, followed by a daily dose of 10-15 mg prednisolone. After 12 months, they underwent a second biopsy, and their histological and clinical features were examined.

RESULTS:

Before and after therapy, systolic blood pressure, diastolic blood pressure, serum creatinine and creatinine clearance all remained unchanged. However, urinary protein excretion decreased dramatically, from 1.6+/-1.7 to 0.4+/-0.2 g/day (P<0.005). Furthermore, computerized imaging revealed a significant reduction of the mesangial matrix index (MMI) from 14.5+/-5.2 to 9.5+/-3.6% (P<0.001). The numbers of sclerosing glomeruli did not change.

CONCLUSIONS:

Steroid therapy reduces mesangial matrix accumulation and reduces urinary protein excretion in advanced IgAN.

• Authors: Minoru Kuriki, Koichi Asahi, Kenichiro Asano, Kaoru Sakurai, Masaaki Eiro, Hodaka Suzuki, Kazuo Watanabe, Tetsuo Katoh, Tsuyoshi Watanabe
• Journal: Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association (Nephrol Dial Transplant) Vol. 18 Issue 7 Pg. 1311-5 (Jul 2003) ISSN: 0931-0509 [Print] England
• PMID: 12808167 (Publication Type: Journal Article)

Chemical References

• Anti-Inflammatory Agents
• Prednisolone
• Methylprednisolone

Topics

• Adult
• Anti-Inflammatory Agents (administration & dosage, pharmacology, therapeutic use)
• Dose-Response Relationship, Drug
• Drug Administration Schedule
• Extracellular Matrix (drug effects, pathology)
• Female
• Follow-Up Studies
• Glomerular Mesangium (drug effects, pathology)
• Glomerulonephritis, IGA (drug therapy, pathology, urine)
• Humans
• Image Interpretation, Computer-Assisted
• Male
• Methylprednisolone (administration & dosage, pharmacology, therapeutic use)
• Middle Aged
• Prednisolone (administration & dosage, pharmacology, therapeutic use)
• Prognosis
• Severity of Illness Index
• Time Factors