Clinicopathologic Changes in Children with Immunoglobulin A Nephritis and Henoch-Schonlein Purpura Nephritis after Cyclosporine A and Angiotensin-converting Enzyme Inhibitor Treatment
Journal of the Korean Society of Pediatric Nephrology
;
: 92-100, 2013.
Article
in English
| WPRIM
| ID: wpr-75955
ABSTRACT
PURPOSE:
To investigate the clinicopathologic effects of cyclosporine A (CsA) in children with diseases characterized by mesangial immunoglobulin A deposits such as immunoglobulin A nephropathy (IgAN) and Henoch-Schonlein purpura nephritis (HSPN).METHODS:
We retrospectively reviewed the clinicopathologic outcomes of 54 children (IgAN, 36; HSPN, 18) treated with CsA. The starting dose of CsA was 5 mg/kg per day, and it was administered in 2 divided doses. The degree of proteinuria and pathologic changes in renal biopsies were evaluated before and after CsA treatment.RESULTS:
The mean protein to creatinine ratio decreased from 3.7+/-1.5 to 0.6+/-0.4 (P<0.001), and 32 (59.2%) children achieved complete remission of proteinuria after 1-year CsA treatment. Among the 54 children, 24 maintained normal renal function and 25 exhibited microscopic hematuria or proteinuria at the end of CsA treatment. In the HSPN group, 3 children whose initial biopsies indicated class IIIb disease showed class II disease on follow-up, and the follow-up biopsies of 2 children who had class II disease indicated the same class II disease. In the IgAN group, cortical tubular atrophy occurred in 1 child, and no child with IgAN had cortical interstitial fibrosis or tubular atrophy after 1-year CsA treatment. No significant complications were found in the children treated with CsA.CONCLUSION:
Our findings indicate that CsA treatment is effective and beneficial in reducing massive proteinuria and preventing progression to end-stage renal failure in children with glomerular diseases characterized by IgA deposits, such as IgAN and HSPN, within 1 year of treatment.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Proteinuria
/
IgA Vasculitis
/
Atrophy
/
Biopsy
/
Fibrosis
/
Immunoglobulin A
/
Immunoglobulins
/
Retrospective Studies
/
Follow-Up Studies
/
Cyclosporine
Type of study:
Observational study
/
Prognostic study
Limits:
Child
/
Humans
Language:
English
Journal:
Journal of the Korean Society of Pediatric Nephrology
Year:
2013
Type:
Article
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