Prednisolone and azathioprine in IgA nephropathy - a ten-year follow-up study.

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Abstract

Immunoglobulin A nephropathy (IgAN) is one of the most common primary glomerular diseases. Although its clinical course is usually benign, some patients develop end-stage renal failure (ESRF). The role of immunosuppressive drugs in the treatment of IgAN remains controversial. The effect of treatment with prednisolone and azathioprine and the clinical and histological parameters related to a poor outcome are examined retrospectively in this analysis.

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Corticosteroids in IgA nephropathy: a randomised controlled trial

Claudio Pozzi, PierGiorgio Bolasco, GianBattista Fogazzi … (1999)

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A controlled trial of fish oil in IgA nephropathy. Mayo Nephrology Collaborative Group.

Dennis Spencer, James Donadio, Aaron K. Holley … (1994)

The n-3 fatty acids in fish oil affect eicosanoid and cytokine production and therefore have the potential to alter renal hemodynamics and inflammation. The effects of fish oil could prevent immunologic renal injury in patients with IgA nephropathy. In a multicenter, placebo-controlled, randomized trial we tested the efficacy of fish oil in patients with IgA nephropathy who had persistent proteinuria. The daily dose of fish oil was 12 g; the placebo was a similar dose of olive oil. Serum creatinine concentrations, elevated in 68 percent of the patients at base line, and creatinine clearance were measured for two years. The primary end point was an increase of 50 percent or more in the serum creatinine concentration at the end of the study. Fifty-five patients were assigned to receive fish oil, and 51 to receive placebo. According to Kaplan-Meier estimation, 3 patients (6 percent) in the fish-oil group and 14 (33 percent) in the placebo group had increases of 50 percent or more in their serum creatinine concentrations during treatment (P = 0.002). The annual median changes in the serum creatinine concentrations were 0.03 mg per deciliter (2.7 mumol per liter) in the fish-oil group and 0.14 mg per deciliter (12.4 mumol per liter) in the placebo group. Proteinuria was slightly reduced and hypertension was controlled to a comparable degree in both groups. The cumulative percentage of patients who died or had end-stage renal disease was 40 percent in the placebo group after four years and 10 percent in the fish-oil group (P = 0.006). No patient discontinued fish-oil treatment because of adverse effects. In patients with IgA nephropathy, treatment with fish oil for two years retards the rate at which renal function is lost.

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Author and article information

Journal

Journal ID (iso-abbrev): Nephron Clin Pract

Title: Nephron. Clinical practice

Publisher: S. Karger AG

ISSN (Electronic): 1660-2110

ISSN (Print): 1660-2110

Publication date (Electronic): 2003

Volume: 93

Issue: 2

Affiliations

[1 ] Department of Nephrology, University Hospital of Patras, Patras, Greece. dgoumenos@med.upatras.gr

Article

Publisher Item ID: 68522

DOI: 10.1159/000068522

PubMed ID: 12616032

SO-VID: ba3f25e9-426b-4c20-9a93-cb1de3d0ddaf

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