We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Glucocorticoids in the treatment of patients with primary focal segmental glomerulosclerosis and moderate proteinuria.
- Authors
Huang, Jianni; Lin, Li; Xie, Jingyuan; Li, Xiao; Shen, Pingyan; Pan, Xiaoxia; Ren, Hong; Chen, Nan
- Abstract
Background: To compare the efficacy of glucocorticoids in primary focal segmental glomerulosclerosis (pFSGS) patients with moderate proteinuria. Registered at http://www.chictr.org.cn/, study No. ChiCTR-OPN-17012789.Methods: pFSGS patients with urine protein between 1.0 and 3.5 g/24 h were recruited from 2006 to 2016. No decline in urine protein > 50% was observed after 2 months of run-in angiotensin-converting enzyme inhibitors/angiotensin-receptor blockers (ACEI/ARB) treatment. Patients were assigned to study group (glucocorticoids with ACEI/ARB) or control group (ACEI/ARB without glucocorticoids). Variables including 24-h urinary protein, serum albumin and serum creatinine during the trial were recorded. Remission was defined as proteinuria < 0.3 g/24 h or declined > 50%, and our composite end point as > 30% decrease of eGFR or eGFR < 30 ml/min.Results: A total of 102 patients were enrolled (study group N = 52, control group N = 50), and the median follow-up time was 36 (12-117) months without significant difference between groups. During the 12-month follow-up, the remission rate was significantly higher in study group [73.1 vs 50.0% (P = 0.01)], and the initial median response time was 3 months in the study group while 6 in the control group. The end point was reached by 22.2% cases in study group, and 42.0% in control. The medium survival times were study group 72 months and control 57 (P = 0.03). Minor adverse reactions were observed in 10 patients (study group N = 8, control group N = 2).Conclusions: Additional glucocorticoids therapy is more efficacious compared to ACEI/ARB alone in the treatment of patients with pFSGS and moderate proteinuria.
- Subjects
GLUCOCORTICOIDS; NEPHROTIC syndrome; GLOMERULONEPHRITIS; GLOMERULAR filtration rate; PROTEINURIA
- Publication
Clinical & Experimental Nephrology, 2018, Vol 22, Issue 6, p1315
- ISSN
1342-1751
- Publication type
Academic Journal
- DOI
10.1007/s10157-018-1585-z