title: Corticosteroid therapy in IgA nephropathy with minimal change-like lesions: a single-centre cohort study.
abstract: BACKGROUND
  There is a lack of high-quality evidence that advocates the use of corticosteroids for IgA nephropathy (IgAN) with minimal change-like lesions (also called IgAN with minimal change disease, MCD-IgAN).
  
  
  METHODS
  Twenty-seven biopsy-proven adult MCD-IgAN patients were enrolled. Daily single dose of 1 mg/kg (maximum 60 mg/day) prednisone was given until complete remission (CR), followed by gradually decreasing dosage. The clinical data were collected from baseline up to 12 weeks of treatment (Certification No. 2011NLY-006, Clinical trials gov ID. NCT01451710).
  
  
  RESULTS
  The patient cohort consisted of 15 males and 12 females. The mean age of the patients was 29.2 ± 10.8 years (range 18-60 years) at the time when they were subject to renal biopsy. All patients had hypoalbuminaemia (23.7 ± 4.13 g/L) and heavy proteinuria (>3.5 g/24 h). Cumulative CR (proteinuria < 0.4 g/24 h) rates were 3.70, 48.1, 92.6 and 100% after 1, 2, 4 and 8 weeks of treatment, respectively. Two cases relapsed after CR, one at 6 weeks of treatment, likely due to failure to follow the corticosteroid withdrawal schedule, and the other one at 8 weeks of treatment accompanied with an upper respiratory infection. Infection, alanine aminotransferase elevation (>2-folds), fasting blood glucose (FBG) elevation (>6.2 mmol/L) and hypopotassaemia (<3.5 mmol/L) occurred in 2, 5, 2 and 5 cases, respectively, but were eliminated after treatment.
  
  
  CONCLUSIONS
  Corticosteroid therapy is likely effective and safe for MCD-IgAN patients.
authors.affiliation: Research Institute of Nephrology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu 210002, China.
authors.forename: Jinquan
authors.initials: J
authors.lastname: Wang
authors.forename: Chenxia
authors.initials: C
authors.lastname: Juan
authors.forename: Qian
authors.initials: Q
authors.lastname: Huang
authors.forename: Caihong
authors.initials: C
authors.lastname: Zeng
authors.forename: Zhihong
authors.initials: Z
authors.lastname: Liu
mesh_terms: D000293:Adolescent; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D015415:Biomarkers / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D005922:Glomerulonephritis, IGA / Q000188:drug therapy* / Q000378:metabolism; D006801:Humans; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D009402:Nephrosis, Lipoid / Q000188:drug therapy* / Q000378:metabolism; D011241:Prednisone / Q000627:therapeutic use*; D011379:Prognosis; D011446:Prospective Studies; D012074:Remission Induction; D055815:Young Adult
chemical_list: D000893:Anti-Inflammatory Agents; D015415:Biomarkers; D011241:Prednisone
keywords: IgA nephropathy; efficiency; minimal change lesion; prednisone; safety