ArticlePediatric nephrology (Berlin, Germany)2025
Retrospective analysis of glucocorticoid therapy in pediatric immunoglobulin A nephropathy: Kidney outcomes and efficacy.
Article in Pediatric nephrology (Berlin, Germany), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe efficacy of glucocorticoid (GC) in the management of immunoglobulin A nephropathy (IgAN) remains highly controversial. The study was conducted to analyze the efficacy and kidney outcomes of GC in the treatment of pediatric IgAN.
methodsUsing the follow-up data of children with chronic kidney disease from the Department of Pediatrics at Jinling Hospital between January 2000 and December 2020, we selected children with primary IgAN who were ≤ 18 years old, confirmed by kidney biopsy, and had undergone regular follow-up for more than 2 years. Patients who had previously used other immunosuppressive agents or had not received renin-angiotensin system blocker (RASB) treatment were excluded. The selected patients were divided into two groups based on their prior treatment regimens: the GC + RASB group and the RASB group. The primary outcome was a composite of a 40% decrease in estimated glomerular filtration rate (eGFR) from baseline, kidney failure, or death due to kidney disease.
resultsA total of 374 patients (149 females) were enrolled, with 230 in the GC + RASB group and 144 in the RASB group. At baseline, the GC + RASB group had lower albumin and higher creatinine levels (all P < 0.05). From 6 months of treatment, the GC + RASB group showed higher urinary protein remission rates (P < 0.05), but hematuria relief was similar between groups. Adverse events, including centripetal obesity, were more frequent in the GC + RASB group (P = 0.001). After a median follow-up of 130.97 months, the GC + RASB group had fewer endpoint events (5.22% vs. 11.11%, P = 0.035) and higher cumulative kidney event-free survival rates, particularly in patients with eGFR > 50 ml/min/1.73 m
conclusionsGC therapy reduced the risk of progression to kidney failure in children with initial eGFR > 50 ml/min/1.73 m
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