Steroids help preserve kidney function in type of kidney disease

Jul 15, 2010

For patients with IgA nephropathy, a type of kidney disease, steroid treatment can prevent or delay loss of kidney function, according to a study appearing in an upcoming issue of the Journal of the American Society of Nephrology (JASN). IgA nephropathy is an autoimmune disease that affects the kidneys and a major cause of end-stage kidney failure in younger people.

"Our study shows that are very useful in patients with IgA nephropathy, and that the addition of an immunosuppressant drug, such as azathioprine, doesn't increase their benefit," comments Claudio Pozzi, MD (Ospedale E. Bassini, Milan).

Patients with IgA nephropathy develop deposits of the protein IgA in the kidneys. The abnormal IgA deposits damage the glomeruli (the filtering units of the kidney), leading to blood and protein in the urine. Previous studies have shown that steroids can reduce urine protein levels and help protect kidney function. However, some patients develop progressive kidney disease, despite steroid treatment.

For the new study, 207 patients with IgA nephropathy were randomly assigned to receive steroids, alone or with the immunosuppressant drug azathioprine. The researchers wanted to see if a more approach using azathioprine—most commonly used to prevent rejection after organ transplantation—could produce better outcomes.

However, there were no major differences in the results with steroids alone or steroids plus azathioprine. After 5 years' follow-up, nearly 90 percent of patients in both groups were alive without progressive kidney disease. In contrast, patients receiving had more complications and side effects.

The study is the largest clinical trial of IgA nephropathy to date and provides important confirmation that steroids can halt or slow the progression toward advanced kidney disease. "The number of enrolled patients and the length of follow-up make the results very strong," Pozzi says.

All patients in the study had normal or only slightly reduced kidney function. "However, IgA nephropathy is frequently a silent disease that is not diagnosed until kidney function is already damaged," Pozzi adds. "We want to verify if this treatment could be useful to slow down the progression of kidney disease in patients with severe renal insufficiency."

The study did not address the role of drugs called renin-angiotensin system (RAS) blockers. At the time the study began, RAS blockers were sometimes used in patients with causing protein in the urine, but not always. "In the following years, RAS blockade has become more frequent in everyday clinical practice," Pozzi says. "Nearly 40 percent of the patients in our study started these drugs during follow-up." However, the preservation of kidney function may reflect more the effect of steroids, the researchers believe. Two recent studies found that steroids combined with RAS blockers are more effective than RAS blockers alone.

Explore further: A novel 'man and machine' decision support system makes malaria diagnostics more effective

More information: The article, entitled "Addition of Azathioprine to Corticosteroids Does Not Benefit Patients with IgA Nephropathy," will appear online on July 15, 2010, doi 10.1681/ASN.2010010117

add to favorites email to friend print save as pdf

Related Stories

Uric acid may provide early clues to diabetic kidney disease

Mar 18, 2008

For patients with type 1 diabetes, increased levels of uric acid in the blood may be an early sign of diabetic kidney disease—appearing before any significant change in urine albumin level, the standard screening test, ...

Bodybuilding with steroids damages kidneys

Oct 29, 2009

Athletes who use anabolic steroids may gain muscle mass and strength, but they can also destroy their kidney function, according to a paper being presented at the American Society of Nephrology's 42nd Annual Meeting and Scientific ...

Recommended for you

Senegal closes border as UN warns on Ebola flare-up

2 hours ago

Senegal has become the latest country to seal its border with a west African neighbour to ward off the deadly Ebola virus, as the new UN pointman on the epidemic said preparations must be made for a possible flare-up of the ...

Climate change could see dengue fever come to Europe

2 hours ago

Dengue fever could make headway in popular European holiday destinations if climate change continues on its predicted trajectory, according to research published in open access journal BMC Public Health.

American Ebola doc: 'I am thrilled to be alive'

10 hours ago

Calling it a "miraculous day," an American doctor infected with Ebola left his isolation unit and warmly hugged his doctors and nurses on Thursday, showing the world that he poses no public health threat ...

User comments : 0