title: Complete remission within 2 years predicts a good prognosis after methylprednisolone pulse therapy in patients with IgA nephropathy.
abstract: BACKGROUND
  Pozzi et al. reported the effectiveness of steroid pulse therapy (Pozzi's regimen) in IgA nephropathy (IgAN). The present study was performed to clarify the predictive factors for IgAN patients treated with Pozzi's regimen.
  
  
  METHODS
  One hundred nine IgAN patients treated by Pozzi's regimen were observed for up to 112.6 (median 39.7) months, and remission of proteinuria (PR) and disappearance of urinary abnormalities [complete remission (CR)] after Pozzi's regimen were analyzed. Predictive factors for the glomerular filtration rate (GFR) slopes for up to 5 years were analyzed among 81 patients who were observed for at least 2 years. The outcome of a 50 % increase in sCr was compared between the CR and non-CR groups within 2 years.
  
  
  RESULTS
  Cumulative PR and CR rates increased rapidly until 2 years (54.5 and 46.8 % at 2 years), and then slowly but steadily up to 6 years (72.8 and 66.4 % at 6 years). Baseline characteristics of the CR and non-CR groups within 2 years were similar except for proteinuria. GFR slope was steeper in the non-CR group than in the CR group (-2.44 ± 5.12 vs. -0.32 ± 3.34 ml/min/1.73 m(2)/year). On multivariate analysis, sex and CR within 2 years were associated with GFR slope. Kaplan-Meier analysis demonstrated a better survival rate in CR group patients without a 50 % increase in sCr (p = 0.024).
  
  
  CONCLUSIONS
  Among IgAN patients treated with Pozzi's regimen, CR within 2 years predicts a good prognosis.
authors.affiliation: Department of Nephrology, Internal Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8560, Japan.
authors.forename: Miho
authors.initials: M
authors.lastname: Tatematsu
authors.forename: Yoshinari
authors.initials: Y
authors.lastname: Yasuda
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Morita
authors.forename: Izumi
authors.initials: I
authors.lastname: Sakamoto
authors.forename: Kei
authors.initials: K
authors.lastname: Kurata
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Naruse
authors.forename: Rhohei
authors.initials: R
authors.lastname: Yamamoto
authors.forename: Naotake
authors.initials: N
authors.lastname: Tsuboi
authors.forename: Waichi
authors.initials: W
authors.lastname: Sato
authors.forename: Enyu
authors.initials: E
authors.lastname: Imai
authors.forename: Seiichi
authors.initials: S
authors.lastname: Matsuo
authors.forename: Shoichi
authors.initials: S
authors.lastname: Maruyama
mesh_terms: D000328:Adult; D003404:Creatinine / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate / Q000502:physiology; D005922:Glomerulonephritis, IGA / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D005938:Glucocorticoids / Q000008:administration & dosage* / Q000627:therapeutic use*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008137:Longitudinal Studies; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage* / Q000627:therapeutic use*; D020551:Pulse Therapy, Drug; D012074:Remission Induction; D012189:Retrospective Studies; D012737:Sex Factors; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids; D003404:Creatinine; D008775:Methylprednisolone