Xin yixue (Nov 2022)
Comparable outcomes using oral methylprednisolone vs. prednisone in IgA nephropathy
Abstract
Objective To compare the efficacy and side effects of oral methylprednisolone and prednisone in the treatment of IgA nephropathy. Method A total of 85 IgA nephropathy patients who were treated with oral corticosteroid were retrospectively analyzed. According to the type and frequency of oral corticosteroid, patients were divided into daily methylprednisolone group (MP-QD group(n = 34)： methylprednisolone 0.4 mg/(kg·d), daily prednisone group (PDN-QD group(n = 31)： prednisone 0.5 mg/(kg·d) and alternate day prednisone group (PDN-QOD group(n = 20)： prednisone 0.5 mg/(kg·qod). The clinical data of the patients were analyzed, including age, gender, blood pressure, pathological results, adverse reactions, and changes in serum creatinine and urinary protein quantity after corticosteroid therapy. Results After corticosteroids treatment, the urinary protein quantity was significantly decreased (P < 0.05), while serum creatinine was not significantly changed compared with those before corticosteroids treatment in 3 groups (all P > 0.05). Kaplan-Meier survival analysis showed that the cumulative free adverse reaction survival rate in 3 groups were statistically significant(P < 0.05), and the mean survival time without adverse reaction of the MP-QD group was the shortest. Multivariate Cox regression analysis showed that the risk of adverse reactions in MP-QD group was 2.475 times higher than that in PDN-QD group (P = 0.045) and 5.814 times higher than that in PDN-QOD group (P = 0.019),respectively. Conclusions Oral methylprednisolone or prednisone therapy in patients with IgA nephropathy significantly decreased the excretion of urine protein and no obvious change was found in the level of serum creatinine in 6-month follow-up period. However, more adverse effects were observed in the patients who received oral methylprednisolone.
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