05 aYes versus no The multivariate model A and model B in Table 4 examined the predictive power of UPE <0.4 g/day at 1 year for renal survival after adjusting for pathological
predictors in the Oxford classification and HG, respectively. A UPE <0.4 g/day at 1 year was selected as an independent predictor in both model A and model B. Adverse effects Serious adverse events were not observed Vactosertib in vitro during the study period. Although three patients developed type 2 diabetes during the 6 months of treatment, they showed normal levels of glycosylated HbA1 at 1 year with diet therapy alone. Seven patients developed infections during the steroid therapy: five bacterial infections (tonsillitis, pharyngitis) and two viral infections (influenza). Two females became pregnant during the follow-up and maintained a stable renal function. Discussion The goal of this study was to identify the level of proteinuria
after steroid therapy associated with a favorable renal outcome in IgAN patients. Previous studies by Reich et al. [4], Hwang et al. [5], or Le et al. [6] have demonstrated that the average level of proteinuria during the whole period of follow-up (A-P) was significantly associated with the renal outcome, providing a targeted proteinuria during long-term follow-up. In contrast, we identified a therapeutic indicator of a favorable renal outcome as an early response to the steroid therapy, which might be more practical than A-P, whereas it was not analyzed in the previous studies. We adopted 1 year as the time PLX-4720 purchase to assess the attenuated proteinuria, since another Cox model in our cohort revealed that the values for proteinuria at 1 year were significantly associated with the outcome, whereas those at baseline or 6 months were not (data not shown). In this study, the spline model revealed that the threshold
UPE predicting the outcome was approximately 0.4 g/day. In addition, a multivariate Cox model including the categorized UPE at 1 year revealed that not only the Disappeared category Liothyronine Sodium but also the Mild category were significantly associated with favorable renal survival relative to the Severe category. Therefore, attenuated proteinuria <0.4 g/day at 1 year after treatment can lead to a favorable outcome, as well as the disappearance of proteinuria. The predictive power of UPE <0.4 g/day at 1 year for renal survival was confirmed even after adjusting for pathological predictors determined by the multivariate model (Table 4). Concerning the impact of clinical remission at an early phase on the renal outcome, Tatematsu et al. [20] showed that clinical remission within 2 years after 6 months of steroid therapy was associated with limiting the eGFR decline.