Effect of Immunosuppressive Treatments on Kidney Outcomes After Gross Hematuria-Related Acute Kidney Injury in Older Patients With IgA Nephropathy
Macroscopic hematuria (MH) bouts, frequently accompanied by acute kidney injury (AKI-MH) are one of the most common presentations of IgA nephropathy (IgAN) in the elderly. Immunosuppressive therapies are used in clinical practice; however, no studies have analyzed their efficacy on kidney outcomes....
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| creator | Sevillano, Angel M. Caravaca-Fontán, Fernando Cordero Garcia-Galan, Lucia Fernandez-Juarez, Gema Lopez-Revuelta, Katia Guzmán, Diomaris A. Martín-Reyes, Guillermo Quintana, Luis F. Rodas, Lida M. Sanchez de la Nieta, Maria Dolores Rabasco, Cristina Espinosa, Mario Diaz-Encarnación, Monserrat San Miguel, Luz Barrios, Clara Rodriguez, Eva Garcia, Patricia Valera, Alfonso Peña, Jessy-Korina Shabaka, Amir Velo, Mercedes Sierra, Milagros Gonzalez, Fayna Fernandez-Reyes, Maria José Heras, Manuel Delgado, Patricia Gutierrez, Eduardo Moreno, Juan Antonio Praga, Manuel Sevillano, Angel M. Caravaca-Fontán, Fernando Garcia-Galan, Lucia Cordero Fernandez-Juarez, Gema Lopez-Revuelta, Katia Guzmán, Diomaris A. Martín-Reyes, Guillermo Quintana, Luis F. Rodas, Lida M. Sanchez de la Nieta, Maria Dolores Rabasco, Cristina Espinosa, Mario Diaz-Encarnación, Monserrat San Miguel, Luz Barrios, Clara Rodriguez, Eva Garcia, Patricia Valera, Alfonso Peña, Jessy-Korina Shabaka, Amir Velo, Mercedes Sierra, Milagros Gonzalez, Fayna Fernandez-Reyes, Maria José Heras, Manuel Delgado, Patricia Gutierrez, Eduardo Moreno, Juan Antonio Praga, Manuel |
| description | Macroscopic hematuria (MH) bouts, frequently accompanied by acute kidney injury (AKI-MH) are one of the most common presentations of IgA nephropathy (IgAN) in the elderly. Immunosuppressive therapies are used in clinical practice; however, no studies have analyzed their efficacy on kidney outcomes.
This is a retrospective, multicenter study of a cohort of patients aged ≥50 years with biopsy-proven IgAN presenting with AKI-MH. Outcomes were complete, partial, or no recovery of kidney function at 1 year after AKI-MH, and kidney survival at 1, 2, and 5 years. Propensity score matching (PSM) analysis was applied to balance baseline differences between patients treated with immunosuppression and those not treated with immunosuppression.
The study group consisted of 91 patients with a mean age of 65 ± 15 years, with a mean follow-up of 59 ± 36 months. Intratubular red blood cell (RBC) casts and acute tubular necrosis were found in all kidney biopsies. The frequency of endocapillary hypercellularity and crescents were low. Immunosuppressive therapies (corticosteroids alone or combined with mycophenolate mofetil or cyclophosphamide) were prescribed in 52 (57%) patients, whereas 39 (43%) received conservative treatment. There were no significant differences in the proportion of patients with complete, partial, or no recovery of kidney function at 1 year between patients treated with immunosuppression and those not treated with immunosuppression (29% vs. 36%, 30.8% vs. 20.5% and 40.4 % vs. 43.6%, respectively). Kidney survival at 1, 3, and 5 years was similar among treated and untreated patients (85% vs. 81%, 77% vs. 76% and 72% vs. 66%, respectively). Despite the PSM analysis, no significant differences were observed in kidney survival between the two groups. Fourteen patients (27%) treated with immunosuppression had serious adverse events.
Immunosuppressive treatments do not modify the unfavorable prognosis of patients with IgAN who are aged ≥50 years presenting with AKI-MH, and are frequently associated with severe complications.
[Display omitted] |
| doi_str_mv | 10.1016/j.ekir.2023.05.027 |
| format | Article |
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This is a retrospective, multicenter study of a cohort of patients aged ≥50 years with biopsy-proven IgAN presenting with AKI-MH. Outcomes were complete, partial, or no recovery of kidney function at 1 year after AKI-MH, and kidney survival at 1, 2, and 5 years. Propensity score matching (PSM) analysis was applied to balance baseline differences between patients treated with immunosuppression and those not treated with immunosuppression.
The study group consisted of 91 patients with a mean age of 65 ± 15 years, with a mean follow-up of 59 ± 36 months. Intratubular red blood cell (RBC) casts and acute tubular necrosis were found in all kidney biopsies. The frequency of endocapillary hypercellularity and crescents were low. Immunosuppressive therapies (corticosteroids alone or combined with mycophenolate mofetil or cyclophosphamide) were prescribed in 52 (57%) patients, whereas 39 (43%) received conservative treatment. There were no significant differences in the proportion of patients with complete, partial, or no recovery of kidney function at 1 year between patients treated with immunosuppression and those not treated with immunosuppression (29% vs. 36%, 30.8% vs. 20.5% and 40.4 % vs. 43.6%, respectively). Kidney survival at 1, 3, and 5 years was similar among treated and untreated patients (85% vs. 81%, 77% vs. 76% and 72% vs. 66%, respectively). Despite the PSM analysis, no significant differences were observed in kidney survival between the two groups. Fourteen patients (27%) treated with immunosuppression had serious adverse events.
Immunosuppressive treatments do not modify the unfavorable prognosis of patients with IgAN who are aged ≥50 years presenting with AKI-MH, and are frequently associated with severe complications.
[Display omitted]</description><identifier>ISSN: 2468-0249</identifier><identifier>EISSN: 2468-0249</identifier><identifier>DOI: 10.1016/j.ekir.2023.05.027</identifier><identifier>PMID: 37547537</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>acute kidney injury ; adverse events ; Clinical Research ; IgA nephropathy ; immunosuppression ; kidney failure ; macroscopic hematuria</subject><ispartof>Kidney international reports, 2023-08, Vol.8 (8), p.1596-1604</ispartof><rights>2023 International Society of Nephrology</rights><rights>2023 International Society of Nephrology. Published by Elsevier Inc.</rights><rights>2023 International Society of Nephrology. Published by Elsevier Inc. 2023 International Society of Nephrology</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c407t-633c92676b76d60d1166872366dd3a7d53b5c6f0572e5c91477cf26616da0cb83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10403672/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10403672/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37547537$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sevillano, Angel M.</creatorcontrib><creatorcontrib>Caravaca-Fontán, Fernando</creatorcontrib><creatorcontrib>Cordero Garcia-Galan, Lucia</creatorcontrib><creatorcontrib>Fernandez-Juarez, Gema</creatorcontrib><creatorcontrib>Lopez-Revuelta, Katia</creatorcontrib><creatorcontrib>Guzmán, Diomaris A.</creatorcontrib><creatorcontrib>Martín-Reyes, Guillermo</creatorcontrib><creatorcontrib>Quintana, Luis F.</creatorcontrib><creatorcontrib>Rodas, Lida M.</creatorcontrib><creatorcontrib>Sanchez de la Nieta, Maria Dolores</creatorcontrib><creatorcontrib>Rabasco, Cristina</creatorcontrib><creatorcontrib>Espinosa, Mario</creatorcontrib><creatorcontrib>Diaz-Encarnación, Monserrat</creatorcontrib><creatorcontrib>San Miguel, Luz</creatorcontrib><creatorcontrib>Barrios, Clara</creatorcontrib><creatorcontrib>Rodriguez, Eva</creatorcontrib><creatorcontrib>Garcia, Patricia</creatorcontrib><creatorcontrib>Valera, Alfonso</creatorcontrib><creatorcontrib>Peña, Jessy-Korina</creatorcontrib><creatorcontrib>Shabaka, Amir</creatorcontrib><creatorcontrib>Velo, Mercedes</creatorcontrib><creatorcontrib>Sierra, Milagros</creatorcontrib><creatorcontrib>Gonzalez, Fayna</creatorcontrib><creatorcontrib>Fernandez-Reyes, Maria José</creatorcontrib><creatorcontrib>Heras, Manuel</creatorcontrib><creatorcontrib>Delgado, Patricia</creatorcontrib><creatorcontrib>Gutierrez, Eduardo</creatorcontrib><creatorcontrib>Moreno, Juan Antonio</creatorcontrib><creatorcontrib>Praga, Manuel</creatorcontrib><creatorcontrib>Sevillano, Angel M.</creatorcontrib><creatorcontrib>Caravaca-Fontán, Fernando</creatorcontrib><creatorcontrib>Garcia-Galan, Lucia Cordero</creatorcontrib><creatorcontrib>Fernandez-Juarez, Gema</creatorcontrib><creatorcontrib>Lopez-Revuelta, Katia</creatorcontrib><creatorcontrib>Guzmán, Diomaris A.</creatorcontrib><creatorcontrib>Martín-Reyes, Guillermo</creatorcontrib><creatorcontrib>Quintana, Luis F.</creatorcontrib><creatorcontrib>Rodas, Lida M.</creatorcontrib><creatorcontrib>Sanchez de la Nieta, Maria Dolores</creatorcontrib><creatorcontrib>Rabasco, Cristina</creatorcontrib><creatorcontrib>Espinosa, Mario</creatorcontrib><creatorcontrib>Diaz-Encarnación, Monserrat</creatorcontrib><creatorcontrib>San Miguel, Luz</creatorcontrib><creatorcontrib>Barrios, Clara</creatorcontrib><creatorcontrib>Rodriguez, Eva</creatorcontrib><creatorcontrib>Garcia, Patricia</creatorcontrib><creatorcontrib>Valera, Alfonso</creatorcontrib><creatorcontrib>Peña, Jessy-Korina</creatorcontrib><creatorcontrib>Shabaka, Amir</creatorcontrib><creatorcontrib>Velo, Mercedes</creatorcontrib><creatorcontrib>Sierra, Milagros</creatorcontrib><creatorcontrib>Gonzalez, Fayna</creatorcontrib><creatorcontrib>Fernandez-Reyes, Maria José</creatorcontrib><creatorcontrib>Heras, Manuel</creatorcontrib><creatorcontrib>Delgado, Patricia</creatorcontrib><creatorcontrib>Gutierrez, Eduardo</creatorcontrib><creatorcontrib>Moreno, Juan Antonio</creatorcontrib><creatorcontrib>Praga, Manuel</creatorcontrib><creatorcontrib>Spanish Group for the Study of Glomerular Diseases (GLOSEN)</creatorcontrib><title>Effect of Immunosuppressive Treatments on Kidney Outcomes After Gross Hematuria-Related Acute Kidney Injury in Older Patients With IgA Nephropathy</title><title>Kidney international reports</title><addtitle>Kidney Int Rep</addtitle><description>Macroscopic hematuria (MH) bouts, frequently accompanied by acute kidney injury (AKI-MH) are one of the most common presentations of IgA nephropathy (IgAN) in the elderly. Immunosuppressive therapies are used in clinical practice; however, no studies have analyzed their efficacy on kidney outcomes.
This is a retrospective, multicenter study of a cohort of patients aged ≥50 years with biopsy-proven IgAN presenting with AKI-MH. Outcomes were complete, partial, or no recovery of kidney function at 1 year after AKI-MH, and kidney survival at 1, 2, and 5 years. Propensity score matching (PSM) analysis was applied to balance baseline differences between patients treated with immunosuppression and those not treated with immunosuppression.
The study group consisted of 91 patients with a mean age of 65 ± 15 years, with a mean follow-up of 59 ± 36 months. Intratubular red blood cell (RBC) casts and acute tubular necrosis were found in all kidney biopsies. The frequency of endocapillary hypercellularity and crescents were low. Immunosuppressive therapies (corticosteroids alone or combined with mycophenolate mofetil or cyclophosphamide) were prescribed in 52 (57%) patients, whereas 39 (43%) received conservative treatment. There were no significant differences in the proportion of patients with complete, partial, or no recovery of kidney function at 1 year between patients treated with immunosuppression and those not treated with immunosuppression (29% vs. 36%, 30.8% vs. 20.5% and 40.4 % vs. 43.6%, respectively). Kidney survival at 1, 3, and 5 years was similar among treated and untreated patients (85% vs. 81%, 77% vs. 76% and 72% vs. 66%, respectively). Despite the PSM analysis, no significant differences were observed in kidney survival between the two groups. Fourteen patients (27%) treated with immunosuppression had serious adverse events.
Immunosuppressive treatments do not modify the unfavorable prognosis of patients with IgAN who are aged ≥50 years presenting with AKI-MH, and are frequently associated with severe complications.
[Display omitted]</description><subject>acute kidney injury</subject><subject>adverse events</subject><subject>Clinical Research</subject><subject>IgA nephropathy</subject><subject>immunosuppression</subject><subject>kidney failure</subject><subject>macroscopic 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Patricia</creatorcontrib><creatorcontrib>Valera, Alfonso</creatorcontrib><creatorcontrib>Peña, Jessy-Korina</creatorcontrib><creatorcontrib>Shabaka, Amir</creatorcontrib><creatorcontrib>Velo, Mercedes</creatorcontrib><creatorcontrib>Sierra, Milagros</creatorcontrib><creatorcontrib>Gonzalez, Fayna</creatorcontrib><creatorcontrib>Fernandez-Reyes, Maria José</creatorcontrib><creatorcontrib>Heras, Manuel</creatorcontrib><creatorcontrib>Delgado, Patricia</creatorcontrib><creatorcontrib>Gutierrez, Eduardo</creatorcontrib><creatorcontrib>Moreno, Juan Antonio</creatorcontrib><creatorcontrib>Praga, Manuel</creatorcontrib><creatorcontrib>Spanish Group for the Study of Glomerular Diseases (GLOSEN)</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Kidney international reports</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sevillano, Angel M.</au><au>Caravaca-Fontán, Fernando</au><au>Cordero Garcia-Galan, Lucia</au><au>Fernandez-Juarez, Gema</au><au>Lopez-Revuelta, Katia</au><au>Guzmán, Diomaris A.</au><au>Martín-Reyes, Guillermo</au><au>Quintana, Luis F.</au><au>Rodas, Lida M.</au><au>Sanchez de la Nieta, Maria Dolores</au><au>Rabasco, Cristina</au><au>Espinosa, Mario</au><au>Diaz-Encarnación, Monserrat</au><au>San Miguel, Luz</au><au>Barrios, Clara</au><au>Rodriguez, Eva</au><au>Garcia, Patricia</au><au>Valera, Alfonso</au><au>Peña, Jessy-Korina</au><au>Shabaka, Amir</au><au>Velo, Mercedes</au><au>Sierra, Milagros</au><au>Gonzalez, Fayna</au><au>Fernandez-Reyes, Maria José</au><au>Heras, Manuel</au><au>Delgado, Patricia</au><au>Gutierrez, Eduardo</au><au>Moreno, Juan Antonio</au><au>Praga, Manuel</au><au>Sevillano, Angel M.</au><au>Caravaca-Fontán, Fernando</au><au>Garcia-Galan, Lucia Cordero</au><au>Fernandez-Juarez, Gema</au><au>Lopez-Revuelta, Katia</au><au>Guzmán, Diomaris A.</au><au>Martín-Reyes, Guillermo</au><au>Quintana, Luis F.</au><au>Rodas, Lida M.</au><au>Sanchez de la Nieta, Maria Dolores</au><au>Rabasco, Cristina</au><au>Espinosa, Mario</au><au>Diaz-Encarnación, Monserrat</au><au>San Miguel, Luz</au><au>Barrios, Clara</au><au>Rodriguez, Eva</au><au>Garcia, Patricia</au><au>Valera, Alfonso</au><au>Peña, Jessy-Korina</au><au>Shabaka, Amir</au><au>Velo, Mercedes</au><au>Sierra, Milagros</au><au>Gonzalez, Fayna</au><au>Fernandez-Reyes, Maria José</au><au>Heras, Manuel</au><au>Delgado, Patricia</au><au>Gutierrez, Eduardo</au><au>Moreno, Juan Antonio</au><au>Praga, Manuel</au><aucorp>Spanish Group for the Study of Glomerular Diseases (GLOSEN)</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effect of Immunosuppressive Treatments on Kidney Outcomes After Gross Hematuria-Related Acute Kidney Injury in Older Patients With IgA Nephropathy</atitle><jtitle>Kidney international reports</jtitle><addtitle>Kidney Int Rep</addtitle><date>2023-08-01</date><risdate>2023</risdate><volume>8</volume><issue>8</issue><spage>1596</spage><epage>1604</epage><pages>1596-1604</pages><issn>2468-0249</issn><eissn>2468-0249</eissn><abstract>Macroscopic hematuria (MH) bouts, frequently accompanied by acute kidney injury (AKI-MH) are one of the most common presentations of IgA nephropathy (IgAN) in the elderly. Immunosuppressive therapies are used in clinical practice; however, no studies have analyzed their efficacy on kidney outcomes.
This is a retrospective, multicenter study of a cohort of patients aged ≥50 years with biopsy-proven IgAN presenting with AKI-MH. Outcomes were complete, partial, or no recovery of kidney function at 1 year after AKI-MH, and kidney survival at 1, 2, and 5 years. Propensity score matching (PSM) analysis was applied to balance baseline differences between patients treated with immunosuppression and those not treated with immunosuppression.
The study group consisted of 91 patients with a mean age of 65 ± 15 years, with a mean follow-up of 59 ± 36 months. Intratubular red blood cell (RBC) casts and acute tubular necrosis were found in all kidney biopsies. The frequency of endocapillary hypercellularity and crescents were low. Immunosuppressive therapies (corticosteroids alone or combined with mycophenolate mofetil or cyclophosphamide) were prescribed in 52 (57%) patients, whereas 39 (43%) received conservative treatment. There were no significant differences in the proportion of patients with complete, partial, or no recovery of kidney function at 1 year between patients treated with immunosuppression and those not treated with immunosuppression (29% vs. 36%, 30.8% vs. 20.5% and 40.4 % vs. 43.6%, respectively). Kidney survival at 1, 3, and 5 years was similar among treated and untreated patients (85% vs. 81%, 77% vs. 76% and 72% vs. 66%, respectively). Despite the PSM analysis, no significant differences were observed in kidney survival between the two groups. Fourteen patients (27%) treated with immunosuppression had serious adverse events.
Immunosuppressive treatments do not modify the unfavorable prognosis of patients with IgAN who are aged ≥50 years presenting with AKI-MH, and are frequently associated with severe complications.
[Display omitted]</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>37547537</pmid><doi>10.1016/j.ekir.2023.05.027</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 2468-0249 |
| ispartof | Kidney international reports, 2023-08, Vol.8 (8), p.1596-1604 |
| issn | 2468-0249 2468-0249 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_10403672 |
| source | DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Alma/SFX Local Collection |
| subjects | acute kidney injury adverse events Clinical Research IgA nephropathy immunosuppression kidney failure macroscopic hematuria |
| title | Effect of Immunosuppressive Treatments on Kidney Outcomes After Gross Hematuria-Related Acute Kidney Injury in Older Patients With IgA Nephropathy |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-06T15%3A45%3A33IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Effect%20of%20Immunosuppressive%20Treatments%20on%20Kidney%20Outcomes%20After%20Gross%20Hematuria-Related%20Acute%20Kidney%20Injury%20in%20Older%20Patients%20With%20IgA%20Nephropathy&rft.jtitle=Kidney%20international%20reports&rft.au=Sevillano,%20Angel%20M.&rft.aucorp=Spanish%20Group%20for%20the%20Study%20of%20Glomerular%20Diseases%20(GLOSEN)&rft.date=2023-08-01&rft.volume=8&rft.issue=8&rft.spage=1596&rft.epage=1604&rft.pages=1596-1604&rft.issn=2468-0249&rft.eissn=2468-0249&rft_id=info:doi/10.1016/j.ekir.2023.05.027&rft_dat=%3Cproquest_pubme%3E2847345763%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2847345763&rft_id=info:pmid/37547537&rft_els_id=S2468024923013359&rfr_iscdi=true |