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      Can Immunosuppressive Therapy Be Useful in IgA Nephropathy when the ‘Point of No Return’ Has Already Been Exceeded?

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      Nephron

      S. Karger AG

      IgA nephropathy, Steroids, Immunosuppressive therapy, Chronic renal failure

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          Abstract

          Immunosuppressive treatment of IgA nephropathy (IgAN) has been a controversial issue since many years, mainly because of skepticism on awaited results and fear of possible side effects. Some authors proposed the existence of a ‘point of no return’, after which the worsening in renal function becomes inexorable and treatment ineffective. Indeed, the decision to treat these patients is easily followed by disappointment due to lack of favorable results. We report the case of a 24-year-old woman with a diagnosis of IgAN with advanced sclerosis and chronic renal failure. After treatment with a 6-month steroid course, she experienced a long-lasting stabilization of renal function (serum creatinine) and decrease in proteinuria (from 2.9 to 0.46 g/24 h) that still persisted at the end of follow-up (48 months). Analysis of this case and review of the literature suggest that immunosuppressive treatment could delay the beginning of renal replacement therapy in the advanced phase of IgAN. However, the results of long-term, randomized, controlled, adequately sized trials are awaited.

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          Most cited references 1

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          Corticosteroids in IgA nephropathy: a randomised controlled trial

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            Author and article information

            Journal
            NEF
            Nephron
            10.1159/issn.1660-8151
            Nephron
            S. Karger AG
            1660-8151
            2235-3186
            2002
            September 2002
            26 September 2002
            : 92
            : 3
            : 699-701
            Affiliations
            Department of Nephrology and Dialysis, ‘A. Manzoni’ Hospital, Lecco, Italy
            Article
            64080 Nephron 2002;92:699–701
            10.1159/000064080
            12372958
            © 2002 S. Karger AG, Basel

            Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

            Page count
            Figures: 1, References: 8, Pages: 3
            Product
            Self URI (application/pdf): https://www.karger.com/Article/Pdf/64080
            Categories
            Preliminary Communication

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