論文

査読有り
2016年2月

Recovery of renal function after glucocorticoid therapy for IgG4-related kidney disease with renal dysfunction

CLINICAL AND EXPERIMENTAL NEPHROLOGY
  • Takako Saeki
  • ,
  • Mitsuhiro Kawano
  • ,
  • Ichiro Mizushima
  • ,
  • Motohisa Yamamoto
  • ,
  • Yoko Wada
  • ,
  • Yoshifumi Ubara
  • ,
  • Hitoshi Nakashima
  • ,
  • Tomoyuki Ito
  • ,
  • Hajime Yamazaki
  • ,
  • Ichiei Narita
  • ,
  • Takao Saito

20
1
開始ページ
87
終了ページ
93
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1007/s10157-015-1140-0
出版者・発行元
SPRINGER

Although renal dysfunction in IgG4-related kidney disease (IgG4-RKD) shows rapid resolution with glucocorticoid therapy, little is known about the appropriate initial glucocorticoid dose for induction therapy or long-term renal outcome.
We retrospectively examined the differences in recovery of renal function according to the dose of glucocorticoid used for induction therapy and the long-term renal outcome in 43 patients with definite IgG4-RKD (mostly IgG4-tubulointerstitial nephritis), in whom the estimated glomerular filtration rate (eGFR) before glucocorticoid therapy was < 60 ml/min.
Most patients were treated with glucocorticoid alone and had been maintained on glucocorticoid. The initial dose of prednisolone employed was a parts per thousand currency sign0.6 mg/kg/day (mean 0.47) in 27 patients (group L), and > 0.6 mg/kg/day (mean 0.81) in 16 patients (group H). In both groups, the pretreatment eGFR was significantly improved at 1 month after the start of glucocorticoid therapy and the degree of improvement showed no significant inter-group difference. Relapse of IgG4-RKD occurred in 16.7 % of the group L patients and 13.3 % of the group H patients (p = 0.78). Among 29 patients who were followed up for over 36 months (mean 74 months) and had been maintained on glucocorticoid, none showed progression to end-stage renal disease and there was no significant difference between eGFR at 1 month after treatment and eGFR at the last review.
In glucocorticoid monotherapy for IgG4-RKD, a moderate dose is sufficient for induction, and recovery of renal function can be maintained for a long period on low-dose maintenance, although relapse can occur even in patients receiving maintenance therapy.

Web of Science ® 被引用回数 : 15

リンク情報
DOI
https://doi.org/10.1007/s10157-015-1140-0
Web of Science
https://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=JSTA_CEL&SrcApp=J_Gate_JST&DestLinkType=FullRecord&KeyUT=WOS:000370376200010&DestApp=WOS_CPL

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