Comparison of the Therapeutic Efficacy of Methylprednisolone Pulse Therapy and Oral Steroid Therapy in Children with IgA Nephropathy and HSP Nephritis Combined with Proteinuria.

, Ahn, Ji Young; , Moon, Jung Eun; , Hwang, Young Ju; , Choi, Bong Seok; , Ko, Cheol Woo; , Cho, Min Hyun

doi:2014.18.1.24

Child Kidney Dis > Volume 18(1); 2014 > Article

Original Article

J Korean Soc Pediatr Nephrol 2014;18(1): 24-28. doi: https://doi.org/10.3339/jkspn.2014.18.1.24

Comparison of the Therapeutic Efficacy of Methylprednisolone Pulse Therapy and Oral Steroid Therapy in Children with IgA Nephropathy and HSP Nephritis Combined with Proteinuria.

Ahn, Ji Young , Moon, Jung Eun , Hwang, Young Ju , Choi, Bong Seok , Ko, Cheol Woo , Cho, Min Hyun

Department of Pediatrics, Kyungpook National University School of Medicine, Daegu, Republic of Korea. chomh@knu.ac.kr

ABSTRACT

PURPOSE: The purpose of this study was to assess the therapeutic efficacy of methylprednisolone pulse therapy in children with IgA nephropathy and Henoch-Schonlein Purpura (HSP) nephritis combined with proteinuria. METHODS: We retrospectively reviewed the clinical records of 21 patients who were diagnosed with IgA nephropathy and HSP nephritis based on percutaneous renal biopsy. Of the 21 patients, 15 were diagnosed with IgA nephropathy and 6 were diagnosed with HSP nephritis. They had mild to severe proteinuria at the time of diagnosis or during follow-up. Group 1 (n=7) received methylprednisolone pulse therapy three times every couple of months, and Group 2 (n=14) received oral steroid therapy. The follow-up periods for Group 1 and 2 were 14.0 (9-54) months and 26.5 (14-34) months, respectively. There was no significant difference in the follow-up duration between the two groups. RESULTS: The average age at diagnosis and biopsy was lower in Group 1 compared to Group 2, but it was not significantly different. At admission, all patients in both groups had hematuria and 5 patients (71.4%) of Group 1 and 14 patients (100%) of Group 2 had proteinuria. Before treatment, there was no significant difference of spot urine protein/creatinine ratio between the two groups. During follow-up, 7 patients of Group 1 (100%) and 10 patients of Group 2 (71.4%) showed complete improvement of proteinuria and the spot urine protein/creatinine ratio in Group 1 was significantly lower than Group 2. CONCLUSION: In patients with IgA nephropathy and HSP nephritis with proteinuria, methylprednisolone pulse therapy was more effective than oral steroid therapy in the reduction of proteinuria. To investigate the effects on long-term prognosis, large-scale prospective studies are needed.

Key words: Proteinuria | IgA nephropathy | Henoch-Schonlein Purpura | Methylprednisolone