Ishod bolesnika s IgA-nefropatijom ovisno o modalitetu liječenja
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| Název: | Ishod bolesnika s IgA-nefropatijom ovisno o modalitetu liječenja |
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| Autoři: | Laganović, Mario, Galešić-Ljubanović, Danica, Knotek, Mladen, Ivković, Vanja, Šenjug, Petar, Margeta, Ivan, Čingel, Branislav |
| Zdroj: | Liječnički vjesnik : glasilo Hrvatskoga liječničkog zbora. 146(5-6):175-183 |
| Informace o vydavateli: | 2024. |
| Rok vydání: | 2024 |
| Témata: | IGA – drug therapy, DISEASE PROGRESSION, PROTEINURIA, KRONIČNA BUBREŽNA BOLEST – etiologija, IGA NEFROPATIJA – farmakoterapija, GLOMERULAR FILTRATION RATE, patologija, KORTIKOSTEROIDI – terapijska uporaba, GLOMERULSKA FILTRACIJA, KIDNEY – pathology, PROTEINURIJA, GLOMERULONEPHRITIS, IMMUNOSUPPRESSION THERAPY, ADRENAL CORTEX HORMONES – therapeutic use, KREATININ – u urinu, IMUNOSUPRESIVNA TERAPIJA, CHRONIC – etiology, BIOPSY, PROGRESIJA BOLESTI, RENAL INSUFFICIENCY, pathology, BUBREG – patologija, CREATININE – urine, BIOPSIJA |
| Popis: | Uvod: IgA-nefropatija (IgAN) ima varijabilnu prezentaciju i prognozu. Međunarodni alat za predviđanje rizika u IgAN-u (IgAN-PT, od engl. International IgA Nephropathy Prediction Tool) predviđa napredovanje bubrežne bolesti do završnog stupnja ili smanjenje procijenjene glomerulske filtracije (eGFR) za 50%. Preporučuje se optimalna suportivna terapija najmanje tri mjeseca, praćena šestomjesečnom primjenom glukokortikoida samo u bolesnika s velikim rizikom napredovanja. Cilj: Istražiti koji su bolesnici imali veću vjerojatnost primiti imunosupresivnu terapiju (IS) te ishode liječenih IS-om. Ispitanici i metode: Retrospektivno kohortno istraživanje 48 bolesnika (33 muškarca), medijana dobi 50 godina (interkvartilni raspon, IQR, od engl. interquartile range 35 – 59), medijana praćenja 43 mjeseca (IQR 18 – 54), liječenih u Kliničkoj bolnici Merkur s novodijagnosticiranim idiopatskim IgAN-om u razdoblju od 2012. do 2021. godine. Rezultati: Imunosupresiju je primilo 17 bolesnika i oni su češće imali mezangijsku (M) (82% prema 54%, p=0,05), endokapilarnu hipercelularnost (E) (65% prema 21%, p=0,004) i polumjesece (C) (41% prema 14%, p=0,04). U odnosu na one bez IS-a nije bilo značajne razlike u eGFR-u kod biopsije (52 (IQR 38 – 81) prema 46 (IQR 30 – 72) ml/min/1,73 m2, p Introduction: IgA nephropathy (IgAN) exhibits variable clinical course and prognosis. To assess prognosis International IgAN Prediction (IgAN-PT) score was developed, and predicts the risk of a 50 % decline in estimated glomerular filtration rate (eGFR) or end-stage renal disease after biopsy. Only patients with a high risk of progression despite three months of optimized supportive care are considered for a six-month course of glucocorticoid therapy. Aim: of this study was to investigate which patients were more likely to receive immunosuppressive therapy (IS) and renal outcomes in patients treated with IS. Patients and methods: The retrospective cohort study included 48 patients (33 male), median age 50 years (interquartile range IQR 35–59), median follow-up 43 months (IQR 18–54), treated at Clinical Hospital Merkur for a newly diagnosed idiopathic IgAN from 2012 to 2021. Results: Seventeen patients were treated with IS. They had more frequently mesangial lesions (M) (82 % vs. 54 %, p=0.05), endocapillary hypercellularity (E) (65 % vs. 21 %, p=0.004) and crescents (C) (41 % vs. 14 %, p=0.04). There was no difference in eGFR at biopsy (52 (IQR 38–81) vs. 46 (IQR 30–72) mL/min/1.73 m2 , p |
| Druh dokumentu: | Article |
| ISSN: | 0024-3477 |
| DOI: | 10.26800/lv-146-5-6-3 |
| Přístupová URL adresa: | https://lijecnicki-vjesnik.hlz.hr/pdf/5-6-2024/LV-146-175.pdf |
| Přístupové číslo: | edsair.dris...01492..63daf80dd37b5280a5c061770beb16ce |
| Databáze: | OpenAIRE |
Nájsť tento článok vo Web of Science | Abstrakt: | Uvod: IgA-nefropatija (IgAN) ima varijabilnu prezentaciju i prognozu. Međunarodni alat za predviđanje rizika u IgAN-u (IgAN-PT, od engl. International IgA Nephropathy Prediction Tool) predviđa napredovanje bubrežne bolesti do završnog stupnja ili smanjenje procijenjene glomerulske filtracije (eGFR) za 50%. Preporučuje se optimalna suportivna terapija najmanje tri mjeseca, praćena šestomjesečnom primjenom glukokortikoida samo u bolesnika s velikim rizikom napredovanja. Cilj: Istražiti koji su bolesnici imali veću vjerojatnost primiti imunosupresivnu terapiju (IS) te ishode liječenih IS-om. Ispitanici i metode: Retrospektivno kohortno istraživanje 48 bolesnika (33 muškarca), medijana dobi 50 godina (interkvartilni raspon, IQR, od engl. interquartile range 35 – 59), medijana praćenja 43 mjeseca (IQR 18 – 54), liječenih u Kliničkoj bolnici Merkur s novodijagnosticiranim idiopatskim IgAN-om u razdoblju od 2012. do 2021. godine. Rezultati: Imunosupresiju je primilo 17 bolesnika i oni su češće imali mezangijsku (M) (82% prema 54%, p=0,05), endokapilarnu hipercelularnost (E) (65% prema 21%, p=0,004) i polumjesece (C) (41% prema 14%, p=0,04). U odnosu na one bez IS-a nije bilo značajne razlike u eGFR-u kod biopsije (52 (IQR 38 – 81) prema 46 (IQR 30 – 72) ml/min/1,73 m2, p<br />Introduction: IgA nephropathy (IgAN) exhibits variable clinical course and prognosis. To assess prognosis International IgAN Prediction (IgAN-PT) score was developed, and predicts the risk of a 50 % decline in estimated glomerular filtration rate (eGFR) or end-stage renal disease after biopsy. Only patients with a high risk of progression despite three months of optimized supportive care are considered for a six-month course of glucocorticoid therapy. Aim: of this study was to investigate which patients were more likely to receive immunosuppressive therapy (IS) and renal outcomes in patients treated with IS. Patients and methods: The retrospective cohort study included 48 patients (33 male), median age 50 years (interquartile range IQR 35–59), median follow-up 43 months (IQR 18–54), treated at Clinical Hospital Merkur for a newly diagnosed idiopathic IgAN from 2012 to 2021. Results: Seventeen patients were treated with IS. They had more frequently mesangial lesions (M) (82 % vs. 54 %, p=0.05), endocapillary hypercellularity (E) (65 % vs. 21 %, p=0.004) and crescents (C) (41 % vs. 14 %, p=0.04). There was no difference in eGFR at biopsy (52 (IQR 38–81) vs. 46 (IQR 30–72) mL/min/1.73 m2 , p |
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| ISSN: | 00243477 |
| DOI: | 10.26800/lv-146-5-6-3 |