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논문분류	춘계학술대회 초록집
제목	Role of immunosuppressive therapy in IgAn nephropathy and predictors of effectiveness
저자	Youngmin Yoon
출판정보	2023; 2023(1):
키워드
초록	Objectives: IgA nephropathy (IgAN) is the most common primary glomerulonephritis in the world. However, it is still unclear which patients with IgAN will benefit from the use of immunosuppressive therapy. The purpose of this study was to identify the characteristics of IgAN patients who may show good response to immunosuppressive therapy. Methods: This retrospective study enrolled 202 adult patients (aged 1880 years) with biopsy-proven IgAN at Samsung Medical Center from 2010-2020. Good prognosis was defined as a reduction of urine protein-to-creatinine ratio (uP/Cr) ≥ 50% or less than 0.5 mg/mg and estimated glomerular filtration rate (eGFR) ≥ 60 mL/min/1.73m2 or less than 5 mL/min/1.73m2 reduction, 1 year from kidney biopsy. Histologic stage was assessed by HASS classification. Results: Mean age was 43 years and 49.5% were male. Among 202 patients, 120 patients were classified to the good prognosis group at 1 year after biopsy. The risk of end-stage kidney disease was significantly higher in the control group than the good prognosis group for up to 10 years. The good prognosis group showed lower mean arterial pressure (good vs. control; 89.9 vs 94.5 mmHg, p = 0.003), higher eGFR (68.6 vs. 56.9 mL/min/1.73m2, p = 0.006), and lower uP/Cr (1.6 vs. 2.0 mg/mgCr, p = 0.041). Immunosuppressive therapy was an independent predictor of good prognosis (odds ratio [OR] 5.146, confidence interval [CI] 2.43510.876, p < 0.001) along with histological stage (OR 0.397, CI 0.1970.798, p = 0.01) and uP/Cr (OR 0.728, CI 0.5800.914, p = 0.006). Among patients who received immunosuppressive therapy, low histological stage was independent predictor of good prognosis (OR 0.308, CI 0.110.865, p = 0.025). Conclusions: Immunosuppressive therapy was associated with good prognosis along with histological stage and uP/Cr. In addition, histological stage may be a marker of response for immunosuppressive therapy.
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