The Optimal Management Strategy for IGA Nephropathy Patients With Different Clinical Presentations - PubMed
7 hours ago
- #IgA nephropathy
- #immunosuppressive therapy
- #renal outcomes
- The study investigates the outcomes of immunosuppressive therapies (IST) in IgA nephropathy (IgAN) patients with different clinical presentations.
- A retrospective cohort study was conducted using data from the TSN-GOLD Working Group database, including 913 patients with at least 6 months of follow-up.
- Patients were categorized into three groups: asymptomatic urinary abnormality (AUA), nephritic syndrome, and nephrotic syndrome.
- IST usage was lowest in the AUA group (38.3%) compared to nephritic (55.2%) and nephrotic (65.1%) groups.
- Steroid therapy was the most common IST (46.2%), followed by mycophenolic acid derivatives, azathioprine, cyclophosphamide, and calcineurin inhibitors.
- The highest remission rate was observed in the AUA group (84.5%), followed by nephritic (76.8%) and nephrotic (77.3%) groups.
- The primary outcome (decline in eGFR ≥50% or ESRD) was reached fastest in the nephrotic group (84 months), followed by nephritic (108 months) and AUA (120 months) groups.
- Multivariate analysis showed nephritic and nephrotic syndromes were associated with higher risks of the primary outcome compared to AUA, while IST reduced the risk.
- The study concludes that IST affects IgAN phenotypes differently, advocating for phenotype-tailored treatment and long-term follow-up.