Steroid therapy in IgA nephropathy in Japan

Summary: We performed prednisone (PSL) therapy which was done in the manner of a prospective multicentre paired controlled trial. We collected 196 patients with biopsy‐proven IgA nephropathy (IgA‐N). the patients were divided into prednisone group receiving prednisone (PSL group, n = 111) and antiplatelet group receiving anti‐platelet drugs only (AP group, n = 85). the mean follow‐up duration was 4.7 ± 2.5 years. We observed that PSL showed beneficial effects in maintaining renal function and decreasing proteinuria for the first 3 years. In stratified subgroups with proteinuria (UP>2 g/day) and with UP>2 g/day and creatinine clearance (Ccr)< = 70 mL/min, the renal death rate at the end of follow‐up in patients of PSL group showed a tendency to be less than that of AP group ( P = 0.067, P =0.095, respectively) although the renal survival rate between both groups were not significantly different. We speculated that steroid therapy might be effective in IgA‐N patients with UP>2 g/day and Ccr< = 70 mL/min. Further trials should be carried out in a properly controlled, randomized, stratified manner with long‐term follow up.