title: Steroid therapy reduces mesangial matrix accumulation in advanced IgA nephropathy.
abstract: BACKGROUND
  Steroid therapy for IgA nephropathy (IgAN) has been reported to ameliorate the long-term prognosis of IgAN, but its mode of action has not been fully elucidated. In this study, we examined the effect of steroids on glomerular morphological changes in IgAN.
  
  
  METHODS
  We examined 16 patients with biopsy-proven IgAN (male/female =11/5, mean age 32.1 years) who were divided into prognosis groups according to criteria set by the Japanese Society of Nephrology. Initially, they received a loading dose of steroids, followed by a daily dose of 10-15 mg prednisolone. After 12 months, they underwent a second biopsy, and their histological and clinical features were examined.
  
  
  RESULTS
  Before and after therapy, systolic blood pressure, diastolic blood pressure, serum creatinine and creatinine clearance all remained unchanged. However, urinary protein excretion decreased dramatically, from 1.6+/-1.7 to 0.4+/-0.2 g/day (P<0.005). Furthermore, computerized imaging revealed a significant reduction of the mesangial matrix index (MMI) from 14.5+/-5.2 to 9.5+/-3.6% (P<0.001). The numbers of sclerosing glomeruli did not change.
  
  
  CONCLUSIONS
  Steroid therapy reduces mesangial matrix accumulation and reduces urinary protein excretion in advanced IgAN.
authors.affiliation: Department of Internal Medicine III, Fukushima Medical University School of Medicine, Japan.
authors.forename: Minoru
authors.initials: M
authors.lastname: Kuriki
authors.forename: Koichi
authors.initials: K
authors.lastname: Asahi
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Asano
authors.forename: Kaoru
authors.initials: K
authors.lastname: Sakurai
authors.forename: Masaaki
authors.initials: M
authors.lastname: Eiro
authors.forename: Hodaka
authors.initials: H
authors.lastname: Suzuki
authors.forename: Kazuo
authors.initials: K
authors.lastname: Watanabe
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Katoh
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Watanabe
mesh_terms: D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005109:Extracellular Matrix / Q000187:drug effects* / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D005920:Glomerular Mesangium / Q000187:drug effects* / Q000473:pathology*; D005922:Glomerulonephritis, IGA / Q000188:drug therapy* / Q000473:pathology* / Q000652:urine; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use*; D008875:Middle Aged; D011239:Prednisolone / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use*; D011379:Prognosis; D012720:Severity of Illness Index; D013997:Time Factors
chemical_list: D000893:Anti-Inflammatory Agents; D011239:Prednisolone; D008775:Methylprednisolone