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KMID : 0811820140180010024
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Journal of Korean Society of Pediatric Nephrology
2014 Volume.18 No. 1 p.24 ~ p.28
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Comparison of the Therapeutic Efficacy of Methylprednisolone Pulse Therapy and Oral Steroid Therapy in Children with IgA Nephropathy and HSP Nephritis Combined with Protein
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Ahn Ji-Young
Moon Jung-Eun
Hwang Young-Ju
Choi Bong-Seok
Ko Cheol-Woo
Cho Min-Hyun
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Abstract
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Purpose: The purpose of this study was to assess the therapeutic efficacy of methylprednisolonepulse therapy in children with IgA nephropathy and Henoch-Schonlein Purpura (HSP) nephritis combined with proteinuria.
Methods: We retro spectively reviewed the clinical records of 21 patients who werediagnosed with IgA nephropathy and HSP nephritis based on percutaneous renalbiopsy. Of the 21 patients, 15 were diagnosed with IgA nephropathy and 6 werediagnosed with HSP nephritis. They had mild to severe proteinuria at the timeof diagnosis or during follow-up. Group 1 (n=7) received methylprednisolonepulse therapy three times every couple of months, and Group 2 (n=14) receivedoral steroid therapy. The follow-up periods for Group 1 and 2 were 14.0 (9-54)months and 26.5 (14-34) months, respectively. There was no significant difference inthe follow-up duration between the two groups.
Results: The average age at diagnosis and biopsy was lower in Group 1 compared toGroup 2, but it was not significantly different. At admission, all patients in bothgroups had hematuria and 5 patients (71.4%) of Group 1 and 14 patients (100 %) ofGroup 2 had proteinuria. Before treatment, there was no significant differenceof spot urine protein/creatinine ratio between the two groups. During followup,7 patients of Group 1 (100%) and 10 patients of Group 2 (71.4%) showedcomplete improvement of proteinuria and the spot urine protein/creatinineratio in Group 1 was significantly lower than Group 2.
Conclusion: In patients with IgA nephropathy and HSP nephritis with proteinuria,methylprednisolone pulse therapy was more effective than oral steroid therapy inthe reduction of proteinuria. To investigate the effects on long-term prognosis,large-scale prospective studies are needed.
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KEYWORD
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Proteinuria, IgA nephropathy, Henoch-Schonlein Purpura, Methylprednisolone
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