Retrospective analysis of glucocorticoid therapy in pediatric immunoglobulin A nephropathy: Kidney outcomes and efficacy.
Background: The 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. Methods: Using the follow-up data of children with chro...
| Publicado en: | Pediatric Nephrology Vol. 40; no. 11; pp. 3447 - 3458 |
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| Autores principales: | , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Springer Nature
Nov2025
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=188353552&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 188353552 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 0931041X EF1 jtl: Pediatric Nephrology issn: 0931041X maglogo: N pubinfo: dt: Nov2025 vid: 40 iid: 11 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 188353552 186638099 188353552 188353552 10.1007/s00467-025-06845-8 188353552 ppf: 3447 ppct: 11 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Retrospective analysis of glucocorticoid therapy in pediatric immunoglobulin A nephropathy: Kidney outcomes and efficacy. aug: au: Wu, Heyan Xia, Zhengkun Zhang, Lidan affil: https://ror.org/00rfd5b88 Pediatric Intensive Care Unit, The Seventh Affiliated Hospital of Sun Yat-sen University, 628 Zhenyuan Road, Guangming District, 518107, Shenzhen, Guangdong Province, China sug: subj: Glomerulonephritis Drug Therapy Glucocorticoids Therapeutic Use Kidney Physiopathology Pediatrics Drug Efficacy Human Male Female Child Adolescence Retrospective Design Record Review Prospective Studies Glomerular Filtration Rate Immunosuppressive Agents Therapeutic Use Albumins Creatinine Disease Progression T-Tests Analysis of Variance Chi Square Test Spearman's Rank Correlation Coefficient Mann-Whitney U Test Kruskal-Wallis Test Kaplan-Meier Estimator Log-Rank Test Confidence Intervals Statistical Significance Data Analysis Software Descriptive Statistics Funding Source Child: 6-12 years Adolescent: 13-18 years Male Female ab: Background: The 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. Methods: Using 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. Results: A 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 m2 and 24 h-UP ≥ 1 g/d (all P < 0.05). Conclusions: GC therapy reduced the risk of progression to kidney failure in children with initial eGFR > 50 ml/min/1.73 m2 and proteinuria ≥ 1 g/d. No additional kidney event-free survival benefit was observed in children with eGFR ≤ 50 ml/min/1.73 m2 or proteinuria < 1 g/d. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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