Glucocorticoids for the treatment of IgA nephropathy: pros and cons. Research data and own experience

O. Chub
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Abstract

IgA nephropathy is the most common pattern of primary glomerular diseases worldwide and remains a leading cause of chronic kidney disease and kidney failure. The incidence of IgA nephropathy is 2.5 per 100,000 population per year. Presentation ranges from isolated haematuria to significant proteinuria, acute kidney injury and even chronic kidney disease. The 10-year risk of progression to end stage kidney disease or halving of GFR is 26 %. The basis of management of IgA nephropathy is goal-directed supportive care in the form of rigorous blood pressure control, use of renin-angiotensin system blockers in the maximum tolerated dose, and a focus on life-style modification that includes smoking cessation, weight management, and restriction of sodium intake. Ho­wever, supportive therapy does not always achieve its goals and cannot affect the autoimmune pathogenesis of the disease, while the role of immunosuppressants and systemic glucocorticoids remains controversial. This review presents an analysis of clinical trials and our own experience regarding the role of steroids and supportive therapy in the treatment of IgA nephropathy.
糖皮质激素治疗IgA肾病:利弊。研究数据和自身经验
IgA肾病是世界范围内最常见的原发性肾小球疾病,并且仍然是慢性肾病和肾衰竭的主要原因。IgA肾病的发病率为每年每10万人2.5例。表现从孤立的血尿到严重的蛋白尿,急性肾损伤甚至慢性肾病。进展到终末期肾病或GFR减半的10年风险为26%。IgA肾病管理的基础是目标导向的支持性护理,其形式为严格的血压控制,以最大耐受剂量使用肾素-血管紧张素系统阻滞剂,并注重改变生活方式,包括戒烟、体重管理和限制钠摄入量。然而,支持治疗并不总是达到其目的,不能影响疾病的自身免疫发病机制,而免疫抑制剂和全身糖皮质激素的作用仍然存在争议。这篇综述分析了临床试验和我们自己的经验,关于类固醇和支持疗法在治疗IgA肾病中的作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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