Renal Failure (Dec 2024)
Immunosuppressive treatment results in patients with primary IgA nephropathy in Turkiye; the data from TSN-GOLD working group
- Aysegul Oruc,
- Abdullah Sumnu,
- Aydın Turkmen,
- Taner Basturk,
- Egemen Cebeci,
- Kenan Turgutalp,
- Hakkı Cetinkaya,
- Müge Uzerk Kibar,
- Nurhan Seyahi,
- Erhan Tatar,
- Metin Ergul,
- Ülver Derici,
- Mehmet Deniz Aylı,
- Musa Pınar,
- Betül Bakar,
- Rümeyza Kazancıoglu,
- Abdülmecit Yıldız,
- Ahmet Burak Dirim,
- Zülfükar Yılmaz,
- Kültigin Turkmen,
- Onur Tunca,
- Mehmet Koc,
- Sim Kutlay,
- Hasan Micozkadıoglu,
- Alper Azak,
- Burcu Boztepe,
- Sedat Ustundag,
- Seda Şafak Ozturk,
- Abdulkadir Unsal,
- Serhat Karadag,
- Gülizar Sahin,
- Ezgi Coşgun Yenigun,
- Necmi Eren,
- Mustafa Gullulu,
- Meltem Gursu,
- Savaş Ozturk
Affiliations
- Aysegul Oruc
- Department of Nephrology, Bursa Uludag University Faculty of Medicine, Bursa, Turkiye
- Abdullah Sumnu
- Department of Nephrology, Medipol University Faculty of Medicine, Istanbul, Turkiye
- Aydın Turkmen
- Department of Nephrology, Istanbul University Faculty of Medicine, Istanbul, Turkiye
- Taner Basturk
- Department of Nephrology, University of Health Sciences, Etfal Hamidiye Training and Research Hospital, Istanbul, Turkiye
- Egemen Cebeci
- Department of Nephrology, Istanbul Provincial Directorate of Health Istanbul Haseki Training and Research Hospital, Istanbul, Turkiye
- Kenan Turgutalp
- Department of Nephrology, Mersin University Faculty of Medicine, Training and Educational Hospital, Mersin, Turkiye
- Hakkı Cetinkaya
- Department of Nephrology, University of Health Sciences, Sultan 2. Abdülhamid Han Training and Research Hospital, Istanbul, Turkiye
- Müge Uzerk Kibar
- Department of Nephrology, Health Ministry of Turkiye Republic Ankara Bilkent City Hospital, Ankara, Turkiye
- Nurhan Seyahi
- Department of Nephrology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkiye
- Erhan Tatar
- Department of Nephrology, Izmir Provincial Directorate of Health Bozyaka Education and Research Hospital, Izmir, Turkiye
- Metin Ergul
- Department of Nephrology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkiye
- Ülver Derici
- Department of Nephrology, Faculty of Medicine, Gazi University, Ankara, Turkiye
- Mehmet Deniz Aylı
- Department of Nephrology, Mınıstry Of Health Dıskapı Yıldırım Beyazıt Traınıng And Research Hospıtal, Ankara, Turkiye
- Musa Pınar
- Department of Nephrology, Faculty of Medicine, Sakarya University, Sakarya, Turkiye
- Betül Bakar
- Department of Nephrology, Ankara Provincial Health Directorate Ankara Training and Research Hospital, Ankara, Turkiye
- Rümeyza Kazancıoglu
- Department of Nephrology, Faculty of Medicine, Bezmialem Vakif Univeristy, Istanbul, Turkiye
- Abdülmecit Yıldız
- Department of Nephrology, Bursa Uludag University Faculty of Medicine, Bursa, Turkiye
- Ahmet Burak Dirim
- Department of Nephrology, Istanbul Provincial Health Directorate ˙Istanbul Bakirköy Dr. Sadi Konuk Education And Research Hospital, Istanbul, Turkiye
- Zülfükar Yılmaz
- Department of Nephrology, Dicle University Faculty of Medicine, Diyarbakır, Turkiye
- Kültigin Turkmen
- Department of Nephrology, Faculty of Medicine Hospital, Necmettin Erbakan University Meram, Konya, Turkiye
- Onur Tunca
- Department of Nephrology, Faculty of Medicine, Afyonkarahisar University of Health Sciences, Afyonkarahisar, Turkiye
- Mehmet Koc
- Department of Nephrology, Faculty of Medicine, Marmara University, Istanbul, Turkiye
- Sim Kutlay
- Department of Nephrology, Faculty of Medicine, Ankara University, Ankara, Turkiye
- Hasan Micozkadıoglu
- Department of Nephrology, Baskent University Faculty of Medicine, Dr. Turgut Noyan Adana Application and Research Hospital, Adana, Turkiye
- Alper Azak
- Department of Nephrology, Balikesir Provincial Health Directorate Atatürk City Hospital, Balıkesir, Turkiye
- Burcu Boztepe
- Department of Nephrology, Istanbul Provincial Health Directorate Haydarpasa Numune Traınıng And Research Hospıtal, Istanbul, Turkiye
- Sedat Ustundag
- Department of Nephrology, Faculty of Medicine, Trakya University, Edirne, Turkiye
- Seda Şafak Ozturk
- Department of Nephrology, Istanbul University Faculty of Medicine, Istanbul, Turkiye
- Abdulkadir Unsal
- Department of Nephrology, University of Health Sciences, Etfal Hamidiye Training and Research Hospital, Istanbul, Turkiye
- Serhat Karadag
- Department of Nephrology, Istanbul Provincial Directorate of Health Istanbul Haseki Training and Research Hospital, Istanbul, Turkiye
- Gülizar Sahin
- Department of Nephrology, University of Health Sciences, Sultan 2. Abdülhamid Han Training and Research Hospital, Istanbul, Turkiye
- Ezgi Coşgun Yenigun
- Department of Nephrology, Ankara Provincial Health Directorate Ankara Training and Research Hospital, Ankara, Turkiye
- Necmi Eren
- Department of Nephrology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkiye
- Mustafa Gullulu
- Department of Nephrology, Bursa Uludag University Faculty of Medicine, Bursa, Turkiye
- Meltem Gursu
- Department of Nephrology, Faculty of Medicine, Bezmialem Vakif Univeristy, Istanbul, Turkiye
- Savaş Ozturk
- Department of Nephrology, Istanbul University Faculty of Medicine, Istanbul, Turkiye
- DOI
- https://doi.org/10.1080/0886022X.2024.2341787
- Journal volume & issue
-
Vol. 46,
no. 1
Abstract
Background Immunoglobulin A (IgA) nephropathy (IgAN) treatment consists of maximal supportive care and, for high-risk individuals, immunosuppressive treatment (IST). There are conflicting results regarding IST. Therefore, we aimed to investigate IST results among IgAN patients in Turkiye.Method The data of 1656 IgAN patients in the Primary Glomerular Diseases Study of the Turkish Society of Nephrology Glomerular Diseases Study Group were analyzed. A total of 408 primary IgAN patients treated with IST (65.4% male, mean age 38.4 ± 12.5 years, follow-up 30 (3–218) months) were included and divided into two groups according to treatment protocols (isolated corticosteroid [CS] 70.6% and combined IST 29.4%). Treatment responses, associated factors were analyzed.Results Remission (66.7% partial, 33.7% complete) was achieved in 74.7% of patients. Baseline systolic blood pressure, mean arterial pressure, and proteinuria levels were lower in responsives. Remission was achieved at significantly higher rates in the CS group (78% vs. 66.7%, p = 0.016). Partial remission was the prominent remission type. The remission rate was significantly higher among patients with segmental sclerosis compared to those without (60.4% vs. 49%, p = 0.047). In the multivariate analysis, MEST-C S1 (HR 1.43, 95% CI 1.08–1.89, p = 0.013), MEST-C T1 (HR 0.68, 95% CI 0.51–0.91, p = 0.008) and combined IST (HR 0.66, 95% CI 0.49–0.91, p = 0.009) were found to be significant regarding remission.Conclusion CS can significantly improve remission in high-risk Turkish IgAN patients, despite the reliance on non-quantitative endpoints for favorable renal outcomes. Key predictors of remission include baseline proteinuria and specific histological markers. It is crucial to carefully weigh the risks and benefits of immunosuppressive therapy for these patients.
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