Source:http://linkedlifedata.com/resource/pubmed/id/14694168
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Predicate | Object |
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rdf:type | |
lifeskim:mentions | |
pubmed:issue |
1
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pubmed:dateCreated |
2003-12-24
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pubmed:abstractText |
Proteinuria plays a causal role in the progression of IgA nephropathy (IgAN). A previous controlled trial showed that steroids are effective in reducing proteinuria and preserving renal function in patients with IgAN. The objective of this study was to evaluate the long-term effectiveness of steroids in IgAN, examine the trend of proteinuria during follow-up (starting from the hypothesis that the degree of reduction in proteinuria may influence IgAN outcome), and evaluate how histologic scores can influence steroid response. A secondary analysis of a multicenter, randomized, controlled trial of 86 adult IgAN patients who were receiving supportive therapy or intravenous methylprednisolone plus oral prednisone for 6 mo was conducted. Ten-year renal survival was significantly better in the steroid than in the control group (97% versus 53%; log rank test P = 0.0003). In the 72 patients who did not reach the end point (doubling in baseline serum creatinine), median proteinuria significantly decreased (1.9 g/24 h at baseline, 1.1 g/24 h after 6 mo, and 0.6 g/24 h after a median of 7 yr). In the 14 progressive patients, proteinuria increased from a median of 1.7 g/24 h at baseline to 2.0 g/24 h after 6 mo and 3.3 g/24 h after a median of 5 yr. Steroids were effective in every histologic class. Cox multivariate regression analyses showed that, in addition to steroids, a low baseline histologic score, a reduction in proteinuria after 6 mo, and no increase in proteinuria during follow-up all were independent predictors of a beneficial outcome. Steroids significantly reduce proteinuria and protect against renal function deterioration in IgAN. The histologic picture and proteinuria during early and late follow-up improve the prediction of outcome, but considerable variability remains outside the model.
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pubmed:language |
eng
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pubmed:journal | |
pubmed:citationSubset |
IM
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pubmed:chemical | |
pubmed:status |
MEDLINE
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pubmed:month |
Jan
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pubmed:issn |
1046-6673
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pubmed:author | |
pubmed:issnType |
Print
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pubmed:volume |
15
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pubmed:owner |
NLM
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pubmed:authorsComplete |
Y
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pubmed:pagination |
157-63
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pubmed:dateRevised |
2004-11-17
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pubmed:meshHeading |
pubmed-meshheading:14694168-Adrenal Cortex Hormones,
pubmed-meshheading:14694168-Angiotensin-Converting Enzyme Inhibitors,
pubmed-meshheading:14694168-Disease Progression,
pubmed-meshheading:14694168-Female,
pubmed-meshheading:14694168-Follow-Up Studies,
pubmed-meshheading:14694168-Glomerulonephritis, IGA,
pubmed-meshheading:14694168-Humans,
pubmed-meshheading:14694168-Hypertension,
pubmed-meshheading:14694168-Male,
pubmed-meshheading:14694168-Proteinuria,
pubmed-meshheading:14694168-Survival Analysis,
pubmed-meshheading:14694168-Time Factors
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pubmed:year |
2004
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pubmed:articleTitle |
Corticosteroid effectiveness in IgA nephropathy: long-term results of a randomized, controlled trial.
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pubmed:affiliation |
Department of Nephrology and Dialysis, A. Manzoni Hospital, Lecco, Italy. c.pozzi@ospedale.lecco.it
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pubmed:publicationType |
Journal Article,
Clinical Trial,
Randomized Controlled Trial,
Multicenter Study
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