Abstract | OBJECTIVE: We compared the effect of treatments in the long-term renal survival of IgA nephropathy. METHODS: RESULTS: Baseline blood pressure, serum creatinine and renal histological findings were similar among the 4 groups; however, the urinary protein level was significantly severer in the PSL group. After a mean follow-up of 7.0+/-0.5 years, end-stage renal disease occurred in 11 patients (31%) in the no treatment group, 5 patients (42%) in the anti-platelet group and 3 patients (8%) in the PSL group, but in only 1 patient (3%) in the ACEI/ARB group. Kaplan-Meier renal survival after 20 years was significantly better in the ACEI/ARB group than in the anti-platelet group or in the no treatment group (p<0.05). The patients that reached complete remission (CR) by steroid therapy showed less baseline urinary protein and milder histological lesions than those who did not reach CR. The non-CR group showed increases in serum creatinine and eGFR reduction rate. CONCLUSION: Treatment with renin-angiotensin system inhibitors showed the greatest improvement of 20-year renal survival in IgA nephropathy patients. Steroid therapy achieved complete remission in some early-stage cases.
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Authors | Kensuke Asaba, Akihiro Tojo, Maristela Lika Onozato, Satoshi Kinugasa, Hiroki Miyazaki, Kazuhisa Miyashita, Yoshio Uehara, Yasunobu Hirata, Kenjiro Kimura, Atsuo Goto, Masao Omata, Toshiro Fujita |
Journal | Internal medicine (Tokyo, Japan)
(Intern Med)
Vol. 48
Issue 11
Pg. 883-90
( 2009)
ISSN: 1349-7235 [Electronic] Japan |
PMID | 19483356
(Publication Type: Comparative Study, Journal Article)
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Chemical References |
- Angiotensin-Converting Enzyme Inhibitors
- Receptors, Angiotensin
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Topics |
- Adult
- Angiotensin-Converting Enzyme Inhibitors
(therapeutic use)
- Female
- Follow-Up Studies
- Glomerulonephritis, IGA
(diagnosis, mortality, therapy)
- Humans
- Male
- Prognosis
- Receptors, Angiotensin
(therapeutic use)
- Retrospective Studies
- Survival Rate
(trends)
- Time Factors
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