Corticosteroid therapy for IgA nephropathy can improve renal outcomes

In a recent study by Yu Wang and colleagues analyzed corticosteroid therapy as a potential treatment for IgA nephropathy (IgAN). This study published in the Nephrology Journal found that corticosteroid therapy may benefit the IgAN patients with moderate proteinuria by helping in proteinuria reduction and renal function preservation.

This comprehensive retrospective cohort study involved a total of 336 patients who were diagnosed with IgAN, with estimated glomerular filtration rates (eGFR) exceeding 15 mL/min/1.73 m² and moderate proteinuria levels ranging from 0.75 to 3.5 g/d.

The patients were divided into a group receiving corticosteroids and the other group undergoing supportive care. The efficacy was measured through complete remission, partial remission and no remission categories. The endpoint of the study was defined as a 40% reduction in eGFR, the onset of end-stage renal disease (ESRD) or renal disease-related death.

The outcomes from the study indicated that corticosteroid-treated individuals faced higher risks in terms of clinical and pathological progression factors. But, after adjusting for confounding factors, the logistic regression analysis surprisingly revealed a significantly higher remission rate in the corticosteroid group. The occurrence of serious adverse events between these two groups did not show any statistically significant difference.

The study employed propensity score matching to further validate these results by pairing 95 sets of patients with similar baseline characteristics. The outcomes demonstrated that corticosteroid-treated patients expressed higher overall and complete remission rates when compared to their untreated counterparts. The relatively short follow-up period of this study prevented the observation of significant differences in the incidence of the defined endpoint and survival analyses. This suggests that the corticosteroid therapy may hold promise for IgAN patients with moderate proteinuria that offers potential benefits in terms of proteinuria reduction and preservation of renal function.

Reference:

Wang, Y., Yu, J., Jiang, Y., Li, J., Yimamuyushan, A., Xia, X., Fan, L., Huang, F., Chen, W., & Liu, Q. (2024). Corticosteroid in IgA nephropathy with moderate proteinuria: A retrospective cohort study. Nephrology (Carlton, Vic.). https://doi.org/10.1111/nep.14269