title: Influence and analysis of low-dosage steroid therapy in severe aristolochic acid nephropathy patients.
abstract: OBJECTIVE
  To investigate the effect of low-dosage steroid therapy in patients with severe aristolochic acid nephropathy (AAN).
  
  
  METHODS
  Forty-three chronic AAN patients in the Peking Union Medical College Hospital and the First Affiliated Hospital of Xinxiang Medical College were included in this study from November 1998 to October 2013. According to the treatment method, the patients were divided into a steroid group (SG, n = 25) and a control group (CG, n = 18). The serum biochemical indicators at the basement in the two groups exhibited no obvious statistical differences. In comparison with the baseline data, the levels of serum creatinine at 3, 6, 9, and 12 months were analyzed. The blood pressure, haemoglobin, serum biochemical indicators, and the side-effects of steroid application were also observed. Urinary macrophage chemoattractant protein-1 (MCP-1) and transforming growth factor-1 (TGF-1) amounts were measured as well.
  
  
  RESULTS
  (i) The serum creatinine content in the CG group was significantly higher than the baseline level during the follow-up(6, 9, and 12 months later), whereas in the SG group it decreased during the 3-6 month period and remained stable within 1 year. (ii) The biochemical indicators, blood pressure, and haemoglobin persisted stable. (iii) The side-effects of low-dosage steroid therapy were not severe and were tolerated by the AAN patients. (4) Urinary MCP-1 and TGF-1 concentrations were positively correlated with serum creatinine and decreased in the SG group.
  
  
  CONCLUSIONS
  Low-dosage steroid therapy reversed or delayed the renal failure progression in severe chronic AAN patients, which may be associated with the suppression of MCP-1 and TGF-β1 activities.
authors.affiliation: Department of Nephrology, Peking Union Medical College Hospital, Beijing, China.|Department of Nephrology, the First Affiliated Hospital of Xinxiang Medical University, Weihui, Hen Nan, China.
authors.forename: Dong-Hong
authors.initials: DH
authors.lastname: Ma
authors.affiliation: Department of Nephrology, Peking Union Medical College Hospital, Beijing, China. zhengfl46@vip.sina.com.
authors.forename: Fa-Lei
authors.initials: FL
authors.lastname: Zheng
authors.affiliation: Department of Nephrology, Peking Union Medical College Hospital, Beijing, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Su
authors.affiliation: Department of Nephrology, Peking Union Medical College Hospital, Beijing, China.
authors.forename: Ming-Xi
authors.initials: MX
authors.lastname: Li
authors.affiliation: Department of Nephrology, the First Affiliated Hospital of Xinxiang Medical University, Weihui, Hen Nan, China.
authors.forename: Ming-Hong
authors.initials: MH
authors.lastname: Guo
mesh_terms: D000368:Aged; D034341:Aristolochic Acids / Q000009:adverse effects*; D002630:Chemotactic Factors / Q000097:blood; D002681:China; D003404:Creatinine / Q000097:blood; D018450:Disease Progression; D004305:Dose-Response Relationship, Drug; D016903:Drug Monitoring / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000139:chemically induced / Q000175:diagnosis / Q000188:drug therapy; D007677:Kidney Function Tests / Q000379:methods; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D013223:Statistics as Topic; D053773:Transforming Growth Factor beta1 / Q000097:blood; D016896:Treatment Outcome
chemical_list: D034341:Aristolochic Acids; D002630:Chemotactic Factors; D005938:Glucocorticoids; D053773:Transforming Growth Factor beta1; D003404:Creatinine
keywords: aristolochic acid nehropathy; macrophage chemoattractant protein-1; steroid; transforming growth factor