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Author Spotlight: Investigating the Potential of Chinese Herbal Medicinal Active Dioscin in Treating IgA Nephropathy
Published on: October 13, 2023
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Steroid therapy in children with IgA nephropathy
Alexandra Cambier1, Olivia Boyer2, Georges Deschenes3
1Pediatric Department of Nephrology and Transplantation, Assistance Publique-Hôpitaux de Paris, Hôpital Robert-Debré, Paris, France. alexandra.cambier@aphp.fr.
Pediatric Nephrology (Berlin, Germany)
|February 20, 2019
Summary
Steroids may not be effective for treating IgA nephropathy (IgAN) in children, especially those with intermediate risk. More research is needed to establish clear treatment guidelines for pediatric IgAN.
Area of Science:
- Pediatric Nephrology
- Immunology
Background:
- IgA nephropathy (IgAN) is a common cause of kidney disease in children.
- A significant percentage of pediatric IgAN patients progress to end-stage kidney disease (ESKD).
- Current treatment guidelines for steroid use in pediatric IgAN are lacking, particularly after the STOP-IgA trial raised concerns in adults.
Purpose of the Study:
- To review the existing evidence on steroid treatment efficacy in children with IgA nephropathy.
- To address the need for clear treatment guidelines for pediatric IgAN.
Main Methods:
- Literature review of available studies on steroid treatment in pediatric IgAN.
- Evaluation of evidence regarding steroid use in conjunction with renin-angiotensin system blockade (RASB).
Main Results:
- The use of steroids in pediatric IgAN is often considered when proteinuria exceeds 0.5 g/l, eGFR drops below 70 ml/min/1.73 m², or biopsy shows inflammation.
- There is a lack of randomized controlled trials (RCTs) specifically in children with IgAN.
- The evidence for steroid efficacy in progressive IgAN in children remains uncertain.
Conclusions:
- The optimal role of steroids in treating pediatric IgAN requires further investigation.
- Consensus on immunosuppressive therapy for progressive IgAN in children is currently absent.
- Evidence-based guidelines for steroid use in pediatric IgAN are critically needed.
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