MISC

1999年1月

A controlled trial of combined therapy for newly diagnosed severe childhood IgA nephropathy

JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY
  • N Yoshikawa
  • H Ito
  • T Sakai
  • Y Takekoshi
  • M Honda
  • M Awazu
  • K Ito
  • K Iitaka
  • Y Koitabashi
  • K Yamaoka
  • K Nakagawa
  • H Nakamura
  • S Matsuyama
  • Y Seino
  • N Takeda
  • S Hattori
  • M Ninomiya
  • 全て表示

10
1
開始ページ
101
終了ページ
109
記述言語
英語
掲載種別
出版者・発行元
LIPPINCOTT WILLIAMS & WILKINS

The most appropriate treatment for patients with IgA nephropathy is controversial, Treatment with prednisolone, azathioprine, heparin-warfarin, and dipyridamole early in the course of disease may prevent immunologic renal injury in children with severe IgA nephropathy. To determine whether similar results can be obtained with a combination of just heparin-warfarin and dipyridamole, the effects of such treatment were compared to those of treatment with prednisolone, azathioprine, heparin-warfarin, and dipyridamole in 78 children with newly diagnosed IEA nephropathy showing diffuse mesangial proliferation. The patients were randomly assigned to receive either prednisolone, azathioprine, heparin-warfarin, and dipyridamole for 2 yr (group 1) or heparin-warfarin and dipyridamole for 2 yr (group 2). ALI of the 40 patients in group 1 and 34 of the 38 patients in group 2 completed the trial. The mean urinary protein excretion fell in group 1 patients (P < 0.0001), but remained unchanged in group 2 patients. The mean serum IgA concentration was reduced in group 1 patients (P = 0.0002), but was unchanged in group 2 patients. BP and creatinine clearance were normal at the end of the trial in all but one group 2 patient, who developed chronic renal insufficiency. The percentage of glomeruli showing sclerosis was unchanged in group I patients, but increased in group 2 patients (P = 0.006). The intensity of mesangial IgA deposits decreased in group 1 patients (P = 0.02), but remained unchanged in soup 2 patients. In conclusion, the present study shows that treatment of children with severe IgA nephropathy with prednisolone, azathioprine, heparin-warfarin, and dipyridamole for 2 yr early in the course of disease reduces immunologic renal injury and prevents increase of sclerosed glomeruli.

リンク情報
Web of Science
https://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=JSTA_CEL&SrcApp=J_Gate_JST&DestLinkType=FullRecord&KeyUT=WOS:000077878300013&DestApp=WOS_CPL
ID情報
  • ISSN : 1046-6673
  • Web of Science ID : WOS:000077878300013

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