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Clinical and Experimental Nephrology

Published in:

01-03-2022 | Original article

Long-term outcomes of IgA nephropathy patients with less than 25% crescents and mild proteinuria

Authors: Qing Jia, Feng Ma, Xiaoxia Yang, Linlin Li, Chunmei Liu, Ruiling Sun, Rong Li, Shiren Sun

Published in: Clinical and Experimental Nephrology | Issue 3/2022

Abstract

Background

Whether immunosuppressive therapy in IgA nephropathy (IgAN) patients with less than 25% crescents (C1) and mild proteinuria can improve the renal outcome is still unclear.

Methods

We recruited 140 IgAN patients with C1 and proteinuria < 1 g/24 h who received supportive care (n = 52) or steroid-based immunosuppressive therapy (n = 88) in Xijing Hospital from July 2008 to December 2016. The primary outcome was the rate of renal function decline.

Results

The median of proteinuria was 575.5 mg/24 h, the fraction of crescents was 7% (5%, 12%) and follow-up time was 69.1 months. The rate of renal function decline [0.5 (− 1.5, 3.2) vs − 0.7 (− 3.5, 0.5) ml/min per 1.73 m² per year; P = 0.01] was slower in steroid-based immunosuppressive therapy group than supportive care group. Multivariate linear regression analyses showed steroid-based immunosuppressive therapy significantly slowed down the rate of renal function decline (β = − 0.220, 95% CI − 3.804 to − 0.449, P = 0.013) after adjusting age, sex, MAP, proteinuria, eGFR, M1, E1, S1, T1–2, the fraction of crescents and RASB. In the matched cohort, the rate of renal function decline was also slower in steroid-based immunosuppressive therapy group. The incidence of adverse events was similar between the two groups.

Conclusion

Steroid-based immunosuppressive therapy may slow down the rate of renal function decline of IgAN patients with C1 and proteinuria ≤ 1 g/24 h.

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Title: Long-term outcomes of IgA nephropathy patients with less than 25% crescents and mild proteinuria
Authors: Qing Jia
Feng Ma
Xiaoxia Yang
Linlin Li
Chunmei Liu
Ruiling Sun
Rong Li
Shiren Sun
Publication date: 01-03-2022
Publisher: Springer Singapore
Published in: Clinical and Experimental Nephrology / Issue 3/2022
Print ISSN: 1342-1751
Electronic ISSN: 1437-7799
DOI: https://doi.org/10.1007/s10157-021-02154-0

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