IgA nephropathy with severe chronic renal failure: A randomized controlled trial of corticosteroids and azathioprine

Claudio Pozzi, Simeone Andrulli, Antonello Pani, Patrizia Scaini, Dario Roccatello, Giambattista Fogazzi, Paola Pecchini, Roberto Rustichelli, Pietro Finocchiaro, Lucia Del Vecchio, Francesco Locatelli

Research output: Contribution to journalArticle

Abstract

Background: Therapeutic nihilism is common in IgA nephropathy (IgAN) and renal insufficiency. Methods: In a randomized controlled trial comparing steroids alone or combined with azathioprine in 253 IgAN patients, we used a separate randomization list for patients with creatinine >2.0 mg/dL. Twenty patients (group 1) were randomized to 3 intravenous pulses of methylprednisolone 1 g at months 1, 3 and 5, and oral prednisone 0.5 mg/kg every other day plus azathioprine 1.5 mg/kg/day for 6 months, followed by oral prednisone 0.2 mg/kg every other day plus azathioprine 50 mg/day for a further 6 months; 26 patients (group 2) received steroids alone. The primary outcome was renal survival (50% increase in plasma creatinine from baseline); secondary outcomes were proteinuria over time and adverse events. Results: Six-year renal survival was not different between the 2 groups (50% vs. 57%; log-rank p=0.34). Median proteinuria decreased during follow-up in the whole population (from 2.45 g/day [interquartile range (IQR) 1.50-3.78] to 1.09 g/day [IQR 0.56- 2.46]; p

Original languageEnglish
Pages (from-to)86-93
Number of pages8
JournalJournal of Nephrology
Volume26
Issue number1
DOIs
Publication statusPublished - Jan 2013

Keywords

  • Azathioprine
  • Chronic kidney disease
  • Hypertension
  • IgA nephropathy
  • Proteinuria
  • Steroids

ASJC Scopus subject areas

  • Nephrology

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  • Cite this

    Pozzi, C., Andrulli, S., Pani, A., Scaini, P., Roccatello, D., Fogazzi, G., Pecchini, P., Rustichelli, R., Finocchiaro, P., Del Vecchio, L., & Locatelli, F. (2013). IgA nephropathy with severe chronic renal failure: A randomized controlled trial of corticosteroids and azathioprine. Journal of Nephrology, 26(1), 86-93. https://doi.org/10.5301/jn.5000110