{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T13:46:12Z","timestamp":1791639972572,"version":"4.3.4"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2021,12,4]],"date-time":"2021-12-04T00:00:00Z","timestamp":1638576000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100008530","name":"Fondo Europeo de Desarrollo Regional","doi-asserted-by":"publisher","award":["PI16\/01685"],"award-info":[{"award-number":["PI16\/01685"]}],"id":[{"id":"10.13039\/501100008530","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100008530","name":"Fondo Europeo de Desarrollo Regional","doi-asserted-by":"publisher","award":["PI19\/01624"],"award-info":[{"award-number":["PI19\/01624"]}],"id":[{"id":"10.13039\/501100008530","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,3,31]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>A randomized controlled trial demonstrated a beneficial effect of corticosteroids (CS)\u00a0+\u00a0cyclophosphamide followed by azathioprine in progressive immunoglobulin A nephropathy (IgAN). Although treatment with CS and mycophenolic acid analogues (MPAAs) remains controversial in IgAN, there is no information about their effects in progressive IgAN.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Patients with progressive IgAN, defined by a decrease in estimated glomerular filtration rate (eGFR) of at least 10\u00a0mL\/min\/1.73 m2 in the 12 months prior to the start of treatment, proteinuria\u00a0\u22650.75\u00a0g\/24 h\u00a0despite maximum tolerated doses of renin\u2013angiotensin system blockers, and persistent haematuria who had received treatment with CS\u00a0+\u00a0MPAA were included in this retrospective study. The main outcome was the difference between the eGFR slope from the start of treatment with CS\u00a0+\u00a0MPAA to the last visit with this treatment with respect to the eGFR slope during the 12 months prior to the start of treatment.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 25 patients were included in the study. The mean duration of CS\u00a0+\u00a0MPAA treatment was 24.7\u00a0\u00b1\u00a015.2\u00a0months. In the 12 months prior to treatment the median rate of kidney function decline was 23 mL\/min\/1.73 m2\/year [interquartile range (IQR) \u201332 to \u201316]. After the onset of treatment, the median eGFR slope was\u00a05 mL\/min\/1.73 m2\/year (IQR 3\u20139; P\u00a0=\u00a00.001 with respect to the 12 months prior to treatment). Proteinuria decreased from 1.8 g\/day (IQR 1.0\u20132.5) at baseline to 0.6 g\/day (IQR 0.3\u20131.2) at the end of treatment (P\u00a0=\u00a00.01) and haematuria disappeared in 40% of patients. There were no serious adverse effects requiring treatment discontinuation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>CS\u00a0+\u00a0MPAA is an effective treatment in IgAN patients with a sustained decline in kidney function accompanied by persistent proteinuria and haematuria despite optimized conservative treatment. Prospective studies are needed to confirm these results.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ckj\/sfab244","type":"journal-article","created":{"date-parts":[[2021,12,2]],"date-time":"2021-12-02T13:36:02Z","timestamp":1638452162000},"page":"771-777","source":"Crossref","is-referenced-by-count":12,"title":["Corticosteroids and mycophenolic acid analogues in immunoglobulin A nephropathy with progressive decline in kidney function"],"prefix":"10.1093","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3342-7628","authenticated-orcid":false,"given":"Ana","family":"Huerta","sequence":"first","affiliation":[{"name":"Department of Nephrology, Hospital Universitario Puerta del Hierro Majadahonda, Madrid, Spain"},{"name":"REDInREN ISCIII 016\/009, Madrid, \u00a0Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"M\u00e9rida","sequence":"additional","affiliation":[{"name":"REDInREN ISCIII 016\/009, Madrid, \u00a0Spain"},{"name":"Department of Nephrology, Hospital Universitario Doce de Octubre, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Medina","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hospital Universitario Infanta Leonor, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Fernandez","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hospital Universitario Doce de Octubre, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo","family":"Gutierrez","sequence":"additional","affiliation":[{"name":"REDInREN ISCIII 016\/009, Madrid, \u00a0Spain"},{"name":"Department of Nephrology, Hospital Universitario Doce de Octubre, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo","family":"Hernandez","sequence":"additional","affiliation":[{"name":"REDInREN ISCIII 016\/009, Madrid, \u00a0Spain"},{"name":"Department of Nephrology, Hospital Universitario Doce de Octubre, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4332-5759","authenticated-orcid":false,"given":"Paula","family":"L\u00f3pez-S\u00e1nchez","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hospital Universitario Puerta del Hierro Majadahonda, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angel","family":"Sevillano","sequence":"additional","affiliation":[{"name":"REDInREN ISCIII 016\/009, Madrid, \u00a0Spain"},{"name":"Department of Nephrology, Hospital Universitario Doce de Octubre, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2114-1385","authenticated-orcid":false,"given":"Jose","family":"Portol\u00e9s","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hospital Universitario Puerta del Hierro Majadahonda, Madrid, Spain"},{"name":"REDInREN ISCIII 016\/009, Madrid, \u00a0Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6921-4811","authenticated-orcid":false,"given":"Hernan","family":"Trimarchi","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hospital Brit\u00e1nico de Buenos Aires, Buenos Aires, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Praga","sequence":"additional","affiliation":[{"name":"REDInREN ISCIII 016\/009, Madrid, \u00a0Spain"},{"name":"Research Institute, Hospital Universitario 12 de Octubre, Madrid, Spain"},{"name":"Department of Medicine, Complutense University, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,12,4]]},"reference":[{"key":"2022033100254558900_bib1","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1159\/000188848","article-title":"Steroid therapy during the early stage of progressive IgA nephropathy. 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