Sequential immunosuppressive therapy in progressive IgA nephropathy

摘要: Backgrounds: Cyclophosphamide and high-dose steroids have been used as limited induction therapy in progressive IgA nephropathy (IgAN) to reduce the loss of renal function proteinuria. We evaluated effect cyclophosphamide pulses (CyP) mycophenolic acid (MPA) sequential on patients with IgAN. Methods: Twenty IgAN advanced failure (median GFR 22 ml/min per 1.73m2) further disease activity (▿GFR -0.8 month) after (CyP; n = 18) or steroid pulse (n 2) were treated mycophenolate mofetil 1 g day for a median 27 months. Results: The monthly was significantly reduced linear regression analysis from -2.4 before CyP -0.12 CyP/MPA (p 0.0009). Estimated survival time prolonged by 65 months 0.0014). Proteinuria decreased 1.7 0.4 g/l during MPA treatment 0.015). In Cox analysis, only proteinuria g1.0g/l an independent risk factor doubling creatinine 0.03). Conclusion: A may arrest slow down reduces even who passed so called ‘point no return’