Significance of first renal biopsy histology for therapeutic selection in IgA nephropathy

Histological differences were analyzed in the first renal biopsy specimen of IgA nephropathy of patients treated with or without the use of steroids, using samples supplied from multi-institutional sources. The application of acuteness and chronicity index indicated that the occurrence of acute intra- and/or extra-capillary lesions was significantly high in progressive cases. Though in present study the dosage or duration of steroids was different in each case, steroids appeared to have been selected preferentially for histologically active cases. Since steroids are used clinically in acute inflammatory disease like SLE, and have been experimentally demonstrated to be effective in suppressing the extent of acute inflammation, effective usage of steroids is recommended in attempts to treat IgA nephritis with high acuteness index scores. The high acuteness index seems appropriate for the selection of steroids for IgA nephropathy.