Die Therapie der progressiven IgA-Nephritis mit Cyclophosphamidpulsen: eine multizentrische prospektive klinische Studie an 21 Patienten
LicenseStandard (Fassung vom 03.05.2003)
For advanced progressive primary IgA nephropathy (IgAN) no established therapy exists. We conducted a prospective trial to evaluate the effect of intravenous cyclophosphamide pulse therapy (CyP) on the course of advanced progressive IgAN. 21 patients (mean age 52 ± 10 years; male/female, 20/1) with biopsy-proven IgAN without crescentic extracapillary proliferation and serum creatinine more than 2.0 mg/dl and/or an increase more than 25 % in the previous 3 months were included. Patients were treated with CyP (750 mg/m2 body surface area) every 4 weeks for 6 months and low dose oral prednisolone. Renal function improved 12.5 % overall per year after therapy in linear regression analysis (p < 0.001). An increase > 25 % of serum creatinine before CyP 1 was observed in 8 patients after 0.7 years (range, 0.3 to 3.0 years), and three patients of these developed end-stage renal disease after 1.2 years (range, 0.7 to 2.8 years). Proteinuria decreased significantly after CyP therapy. A low nadir of white blood cell count (p = 0.025) and platelet count (p = 0.011) was associated with a better renal outcome. In conclusion, CyP therapy and low dose oral prednisolone are effective in preserving renal function in advanced progressive IgAN.
Subject HeadingsCorticosteroide [GND]
Immunglobulin A [GND]
Glomerulonephritis, IGA [MeSH]
Immunosuppressive agents [MeSH]