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KMID : 0882420090770050593
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Korean Journal of Medicine
2009 Volume.77 No. 5 p.593 ~ p.600
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Renoprotective effect of deflazacort in IgA nephropathy with proteinuria
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Jeong Ji-Min
Lim Dae-Hun
Lee Hyung-Chul
Oh Seul-Hyun
Choi Joon-Seok
Park pyung-Kyun
Jung An-Doc
Park Jeong-Woo
Bae Eun-Hui
Ma Seong-Kwon
Kim Soo-Wan
Kim Nam-Ho
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Abstract
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Background/Aims: Steroid therapy is reported to improve the clinical outcome of IgA nephropathy. In addition, recent studies have revealed that deflazacort has fewer side effects than prednisolone. This study examined the effect of steroids and compared the clinical efficacy of deflazacort and prednisolone in patients with IgA nephropathy.
Methods: We retrospectively reviewed 136 patients with biopsy-proven IgA nephropathy who received deflazacort (n=50), prednisolone (n=29), or neither (n=59), and in whom blood pressure was controlled with angiotensin converting enzyme inhibitors or angiotensin receptor blockers. The mean duration of steroid administration was 9.5±9.1 months. The initial clinical status and change in the amount of protein in the 24-hour urine were compared among the three groups.
Results: The baseline characteristics (age, blood pressure, serum creatinine level, initial protein in the 24-hour urine, and creatinine clearance) did not differ significantly among the groups. The decrement of protein in the 24-hour urine was higher in the deflazacort and prednisolone groups, as compared with the control group (4.4±5.4, 4.2±1.5, and 2.1±3.1 g/day, respectively, p=0.013). The increment in the creatinine clearance was higher in the deflazacort and prednisolone groups, as compared with the control group (11.5±16.4, 12.3±26.2, and 4.8±14.91.3±0.9, respectively, p=0.009). There were no significant differences in the above parameters between the deflazacort and prednisolone groups.
Conclusions: Steroid therapy reduces urinary protein excretion in IgA nephropathy, and the clinical efficacy of deflazacort and prednisolone was found to be similar.
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KEYWORD
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Therapeutics, Prednisolone, Glomerulonephritis, IgA
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