[The role of steroids in the treatment of IgA nephropathy].
IgA nephropathy (IgAN) is characterized by a variable natural history. Welldefined risk factors from a clinical point of view are renal function impairment, associated hypertension, and proteinuria, while tubular-interstitial fibrosis constitutes a histological risk factor. These are serious clinical symptoms and histological signs, indicating long-lasting and severe damage. The available therapeutic tools belong essentially to two categories: 1) angiotensin inhibitors and 2) steroids, associated or not with immunosuppressive drugs. ACE inhibitors have limited toxicity and no significant side effects, and nephrologists are inclined to use them in case of moderate proteinuria. Steroids, in some cases associated with immunosuppressive agents, are obviously more demanding for the patient. Decisions must be made by the clinicians regarding the timing and the possible presence of contraindications. Furthermore, the treatment may not yield the expected results and a critical approach by the nephrologist is necessary. This controversy highlights the theoretical and practical issues related to steroid therapy in IgAN and here we discuss the different approaches to indications, doses, duration and route of administration.
Coppo
Rosanna
R
Divisione di Nefrologia, Dialisi e Trapianto, Ospedale Regina Margherita, Torino. rosanna.coppo@unito.it
Pozzi
C
C
Amore
A
A
D054697:Cytostatic Agents / Q000627:therapeutic use; D005922:Glomerulonephritis, IGA / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D013256:Steroids / Q000627:therapeutic use*
D054697:Cytostatic Agents; D013256:Steroids