A Study of mycophenolate and steroids in IGA nephropathy.

Satya Vamseedhar, P (2010) A Study of mycophenolate and steroids in IGA nephropathy. Masters thesis, Christian Medical College, Vellore.


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AIM : IgA Nephropathy (IgAN) has a rapid course in the Indian population. This case control study was performed to study mycophenolate (MPA) in high risk IgAN. METHODS : 41 IgAN cases at high risk of progression (24 hour proteinuria >3grams or e GFR(MDRD) <60ml/min/1.73m2 or mean arterial pressure (MAP) >=107mmHg or glomerulosclerosis involving >=50% of glomeruli) who were treated with MPA (dose controlled with therapeutic drug monitoring) and steroids +/- ACE-I/ARB were compared to two historical control groups, one that received steroids+/- ACE-I/ARB (control 1, n=31) and the other, without immunosuppression +/- ACE-I/ARB (control 2, n=41). RESULTS : Baseline characteristics of 3 groups were similar with respect to age, sex, MAP, proteinuria whereas e GFR in control 1 was higher by 15 ml/min. (p=0.03). Mann- Whitney test was used. In cases, control 1 and control 2, after 3 months of treatment, median percent change in e GFR was 16.93,11.62, -8.23, %change in s. creatinine was - 12.5,-1.17,-1.32 and %change in proteinuria was -58.76, -45.31 and -48.53 respectively. When cases were compared to control 2, there was a significant improvement in e GFR and s.creatinine (p=0.004 and 0.005) respectively, whereas there was a trend towards improvement in proteinuria in cases by 10% (p=0.313).On comparing cases to control 1, there was a trend towards improvement of proteinuria and e GFR in cases by 13% (p=0.548) and 5% (p=0.58) respectively. Sub group analysis of patients in the 3 groups who received ACE-I/ARB revealed similar trends. CONCLUSIONS : In high risk IgAN patients, MPA+steroids+ACE-I/ARB was beneficial with respect to improvement in renal function when compared to ACE-I/ARB alone and there was a trend towards better renal function when compared to steroids + ACE-I/ARB.

Item Type: Thesis (Masters)
Uncontrolled Keywords: mycophenolate ; steroids ; IGA nephropathy.
Subjects: MEDICAL > Nephrology
Depositing User: Kambaraman B
Date Deposited: 11 Jul 2017 07:26
Last Modified: 11 Jul 2017 07:26
URI: http://repository-tnmgrmu.ac.in/id/eprint/1400

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