Русский
The effectiveness of treatment with glucocorticosteroids in immunoglobulin A nephropathy with active proliferative histopathological change
DOI: https://dx.doi.org/10.18565/nephrology.2023.2.19-25
Komissarov K.S., Krasko O.V., Minchenko E.I., Pilotovich V.S.
1) Minsk Scientific and Practical Center for Surgery, Transplantology and Hematology, Minsk, Republic of Belarus; 2) Belarusian Medical Academy of Postgraduate Education, Minsk, Republic of Belarus; 3) Joint Institute for Informatics Problems of the National Academy of Sciences of Belarus, Minsk, Republic of Belarus; 4) 1st City Clinical Hospital, Minsk, Republic of Belarus.
Material and methods. The effectiveness of therapy after 6 months of treatment in 2 groups of patients with IgAN and the presence of histopathological proliferative changes (M1, E1 and/or C1) with glomerular filtration rate >50 ml/min and proteinuria >0.75 g/day (group 1 - ACE inhibitors or ARBs (n=21), group 2 - corticosteroids (n=15)) was evaluated.
Results. Clinical and laboratory parameters improved in both treatment groups, but the overall remission rate in the group 1 was 33%, which was significantly lower compare to the group 2 - 87% (P = 0.023). Patients treated with ACE inhibitors or ARBs had a high incidence of IgAN progression after 6 months of treatment compared with patients treated with corticosteroids (P = 0.001).
Conclusion. Early use of corticosteroids in patients with IgAN and the presence of histopathological proliferative changes provides a significant increase in the incidence of clinical and laboratory remission by 53.4% (P=0.002) without side effects.
About the Autors
Kirill S. Komissarov – Cand. Sci.(Med.), Associate Professor, Head of the Department of Nephrology, Renal Replacement Therapy and Kidney Transplantation, Minsk Scientific and Practical Center for Surgery, Transplantology and Hematology. Address: 8 Semashko st., Minsk,; e-mail: kirill_ka@tut.by. ORCID: 0000-0002-2648-0642.
Olga V. Krasko – Cand. Sci.(Med.), Address: 6 Surganov st., Minsk; e-mail: olga.krasko.ok@gmail.com. ORCID: http://orcid.org/0000-0002-4150-282X.
Elena I. Minchenko – Nephrologist, Department of Nephrology, 1st City Clinical Hospital. Address: 64 Independence Ave., Minsk; e-mail: elena_nefro@mail.ru.
ORCID: 0000-0001-6268-7563.
Valery S. Pilotovich – Dr. Sci. (Med.), Professor at the Department of Urology and Nephrology, Medical Academy of Postgraduate Education.
Address: Bldg. 3, 3 P. Brovka st., Minsk; e-mail: pilotovich@mail.ru. ORCHID: 0000-0001-8256-5889.
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