title: Treatment protocol with pulse and oral steroids for IgA Nephropathy after kidney transplantation.
abstract: BACKGROUND
  No specific treatment for IgA nephropathy (IgAN) after kidney transplantation is currently available.
  
  
  METHODS
  We conducted a retrospective single-center study on 29 patients with biopsy-proven de novo and recurrent IgAN after kidney transplantation, divided into two groups. Group 1 (n = 16) received intravenous methylprednisolone 500 mg per day for three consecutive days at the beginning of months 1, 3 and 5, plus oral prednisone 0.5 mg/kg every other day for 6 months. The control group (n = 13, Group 2) received supportive therapies.
  
  
  RESULTS
  The two groups were comparable for serum creatinine (sCr) and proteinuria at the time of renal biopsy, but differed significantly at the end of follow-up. sCr was 1.8 ± 0.4 mg/dl in Group 1 vs. 2.7 ± 0.9 in Group 2 (p = 0.002), and proteinuria was 0.9 g/day in Group 1 vs. 1.9 in Group 2 (p = 0.04). The composite outcome of death-censored graft loss or doubling of sCr displayed 2 events in Group 1 (12.5 % of the entire group) and 5 events in Group 2 (38.5 % of the entire group), p = 0.19, odds ratio (OR) 4.4 [95 % confidence interval (CI) 0.7-27.8].
  
  
  CONCLUSIONS
  In the absence of therapeutic guidelines for de novo or recurrent IgAN after kidney transplantation, our study reports that therapy with pulse and oral steroids for 6 months is associated with an improved renal function. Nevertheless, further randomized controlled studies in larger patient cohorts are necessary to establish the gold standard treatment.
authors.affiliation: Renal Transplantation Unit 'A. Vercellone', Division of Nephrology Dialysis and Transplantation, Department of Medical Sciences, Città della Salute e della Scienza Hospital and University of Turin, Cso Bramante 88, 10126, Turin, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Messina
authors.affiliation: Renal Transplantation Unit 'A. Vercellone', Division of Nephrology Dialysis and Transplantation, Department of Medical Sciences, Città della Salute e della Scienza Hospital and University of Turin, Cso Bramante 88, 10126, Turin, Italy.
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: di Vico
authors.affiliation: Renal Transplantation Unit 'A. Vercellone', Division of Nephrology Dialysis and Transplantation, Department of Medical Sciences, Città della Salute e della Scienza Hospital and University of Turin, Cso Bramante 88, 10126, Turin, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Ariaudo
authors.affiliation: Division of Pathology, Department of Medical Sciences, University of Turin, Turin, Italy.
authors.forename: Gianna
authors.initials: G
authors.lastname: Mazzucco
authors.affiliation: Renal Transplantation Unit 'A. Vercellone', Division of Nephrology Dialysis and Transplantation, Department of Medical Sciences, Città della Salute e della Scienza Hospital and University of Turin, Cso Bramante 88, 10126, Turin, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Fop
authors.affiliation: Renal Transplantation Unit 'A. Vercellone', Division of Nephrology Dialysis and Transplantation, Department of Medical Sciences, Città della Salute e della Scienza Hospital and University of Turin, Cso Bramante 88, 10126, Turin, Italy.
authors.forename: Giuseppe Paolo
authors.initials: GP
authors.lastname: Segoloni
authors.affiliation: Renal Transplantation Unit 'A. Vercellone', Division of Nephrology Dialysis and Transplantation, Department of Medical Sciences, Città della Salute e della Scienza Hospital and University of Turin, Cso Bramante 88, 10126, Turin, Italy. luigi.biancone@unito.it.
authors.forename: Luigi
authors.initials: L
authors.lastname: Biancone
mesh_terms: D061605:Administration, Intravenous; D000284:Administration, Oral; D000328:Adult; D002985:Clinical Protocols; D003404:Creatinine / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D005922:Glomerulonephritis, IGA / Q000188:drug therapy* / Q000209:etiology; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage*; D008875:Middle Aged; D011241:Prednisone / Q000008:administration & dosage*; D011507:Proteinuria / Q000188:drug therapy; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids; D003404:Creatinine; D011241:Prednisone; D008775:Methylprednisolone
keywords: Corticosteroids; IgA nephropathy; Recurrent glomerulonephritis; Renal transplantation