Abstract | OBJECTIVE: PATIENTS AND METHODS: We retrospectively analyzed the effect of MP pulse therapy in patients with histologically active IgAN (8 males, 12 females) whose estimated glomerular filtration rate was less than 60 mL/min/1.73 m2 (33.4 +/- 13.1, mean +/- SD). The efficacy of the MP pulse therapy was analyzed by calculating the regression coefficients (dL/mg/month) from the slopes of the 1/serum creatinine (Cr), urine protein/ creatinine ratio (g/g x Cr), and the estimated interval from the pulse therapy to dialysis (that is, for Cr to reach 8 mg/dL, as calculated from the slope of 1/Cr) or the actual interval. RESULTS: All patients showed improved regression coefficients (-0.0214 +/- 0.00166 vs. 0.00236 +/- 0.00895, 1 year before vs. after treatment, p < 0.01). The severity of proteinuria decreased significantly from a mean urine protein/ creatinine ratio of 2.9 +/- 1.7 before therapy to 1.1 +/- 0.8 (p < 0.01) at 6 months and 0.8 +/- 0.7(p < 0.01) at 12 months after therapy. Although 7 patients underwent dialysis, the average interval from pulse therapy to dialysis was prolonged from an estimated interval of 1.1 +/- 0.9 years to an actual interval of 4.1 +/- 3.5 years. Six patients showed positive regression coefficients at the last observation (4.1 +/- 3.0 years after therapy). The remaining 7 patients who had not undergone dialysis also showed prolongation of the estimated interval from pulse therapy to dialysis of 5.9 +/- 5.1 years before pulse therapy to 25.7 +/- 20.6 years at the final observation (4.9 +/- 3.5 years after therapy). No serious side effects were observed in any of the patients. CONCLUSION: MP pulse therapy can slow the progression of renal deterioration in patients with active IgAN, even in those patients in whom renal function impairment has set in.
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Authors | Hidekazu Ikeuchi, Keiju Hiromura, Toru Sakairi, Shin Yamashita, Jun Okajo, Takeshi Tomizawa, Shigeo Tamura, Akito Maeshima, Yoriaki Kaneko, Takashi Kuroiwa, Kazue Ueki, Yoshito Tsukada, Hironobu Kawai, Ryoji Wakamatsu, Yoshihisa Nojima |
Journal | Nihon Jinzo Gakkai shi
(Nihon Jinzo Gakkai Shi)
Vol. 50
Issue 2
Pg. 114-21
( 2008)
ISSN: 0385-2385 [Print] Japan |
PMID | 18421967
(Publication Type: English Abstract, Journal Article)
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Chemical References |
- Biomarkers
- Creatinine
- Methylprednisolone
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Topics |
- Adult
- Aged
- Biomarkers
- Creatinine
(blood)
- Dialysis
- Disease Progression
- Female
- Glomerulonephritis, IGA
(diagnosis, drug therapy, physiopathology)
- Humans
- Kidney
(physiopathology)
- Kidney Function Tests
- Male
- Methylprednisolone
(administration & dosage)
- Middle Aged
- Prognosis
- Pulse Therapy, Drug
- Regression Analysis
- Retrospective Studies
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