Steroid therapy in IgA nephropathy: a prospective pilot study in moderate proteinuric cases

Forty-three patients with IgA nephropathy whose proteinuria persisted between 1.0 and 2.0 g/day were assessed in an uncontrolled pilot study of steroid treatment. Fourteen patients receive an initial dose of 40 mg/day of prednisolone, followed by gradual reduction of the dose over an average period of about 19 months. After discontinuation of corticosteroids, they were treated with non-steroid anti-inflammatory drugs and/or anti-thrombocyte drugs to the end of the study. Another 29 patients received non-steroid anti-inflammatory drugs and/or anti-thrombocyte drugs throughout the study. Fourteen patients treated with steroids experienced considerable reduction in proteinuria and maintained renal function over 81 months. In 29 patients treated with non-steroid anti-inflammatory drugs and/or anti-thrombocyte drugs alone, proteinuria did not decrease and renal function deteriorated significantly during 60 months. At the end of the study, differences in degree of proteinuria and in levels of renal function between the steroid and non-steroid groups were statistically significant. In addition, these differences became more distinct in patients with initial creatinine clearance values 70 ml/min or more in both groups. These results suggest that treatment with steroids in IgA nephropathy may be beneficial, especially in the early stage of the disease.