Cellular crescents and segmental glomerular necrosis in IgA nephropathy are indicative of the beneficial effects of corticosteroid therapy.
OBJECTIVE
Recent reports have revealed that corticosteroid (PSL) therapy has a long-term beneficial effect for stabilization of renal function in progressive IgA nephropathy.


METHODS
We analyzed serum creatinine (Cr), daily proteinuria and the results of other routine laboratory examinations during a short-term course of PSL therapy in 28 cases of progressive IgA nephropathy. The cases were divided into two groups according to changes in renal function during the PSL treatment period: group I (15 cases), improved renal function; group II (13 cases), no significant change in renal function.


RESULTS
In group I, serum Cr and proteinuria were significantly decreased, with maximum effects observed at 3 months of PSL therapy, and remained low during the period of treatment. In contrast, group II showed no significant changes in serum Cr levels during the period of therapy, although proteinuria was transiently decreased after 3 months of therapy. Histologically, cellular/fibrocellular (C/F) crescents and/or segmental glomerular necrosis (SGN) occurred with a significantly higher incidence in group I (87%) than in group II (46%) (p < 0.05).


CONCLUSIONS
These results suggested that the early response to PSL in reducing serum Cr and proteinuria by 3 months of treatment may be clinically useful to predict the prognosis of IgA nephropathy and that C/F crescents and/ or SGN may be histologically indicative of the beneficial effects of PSL therapy in IgA nephropathy.
Tomiyoshi
Y
Y
Department of Internal Medicine, Saga Medical School, Nabeshima.
Sakemi
T
T
Ikeda
Y
Y
Ohtsuka
Y
Y
Nakamura
M
M
Fujisaki
T
T
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D003404:Creatinine / Q000097:blood*; D005260:Female; D005922:Glomerulonephritis, IGA / Q000188:drug therapy* / Q000378:metabolism* / Q000473:pathology; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D011237:Predictive Value of Tests; D011241:Prednisone / Q000627:therapeutic use*; D011507:Proteinuria / Q000378:metabolism*; D012189:Retrospective Studies; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D003404:Creatinine; D011241:Prednisone