Clinical and experimental nephrology · 2026
Safety and efficacy of prednisolone, mizoribine and lisinopril combination therapy for severe childhood IgA nephropathy.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Shima Yuko, Mukaiyama Hironobu, Tanaka Yu, Shimabukuro Wataru, Kaito Hiroshi, Tanaka Ryojiro, Nozu Kandai, Iijima Kazumoto, Tokuhara Daisuke, Yoshikawa Norishige, Nakanishi Koichi
Аннотация
BACKGROUND: Angiotensin-converting enzyme inhibitors (ACEi), such as lisinopril, have long been used for childhood IgA nephropathy (cIgAN). A two-year regimen including prednisolone, mizoribine, warfarin, and dipyridamole was previously shown to be superior to prednisolone and mizoribine alone in achieving proteinuria remission. Because warfarin nephropathy has been reported and the cumulative prednisolone dose used in earlier regimens was substantial, we evaluated a new two-year regimen consisting of prednisolone, mizoribine, and lisinopril.
METHODS: Among 567 biopsy‑proven cIgAN cases treated between 1976 and 2022, 93 patients met the criteria for severe cIgAN. Of these, 77 received the previous regimen and 16 received the new regimen. Severe cIgAN was defined as diffuse mesangial proliferation and/or persistent heavy proteinuria (> 1 g/gCr). To adjust for baseline differences in proteinuria, eGFR, and C‑lesions, 1:1 propensity score matching was performed, yielding 15 matched pairs.
RESULTS: Baseline clinicopathological characteristics did not differ significantly between groups. Kaplan-Meier analysis showed that the new regimen was associated with a higher proteinuria remission rate during follow-up (log-rank p = 0.01) and a shorter time to remission (median 1.0 vs. 4.0 years, p = 0.03). Hematuria remission tended to be higher with the new regimen (80.0% vs. 46.7%). Proteinuria recurrence rates were comparable between groups.
CONCLUSIONS: The two‑year regimen of prednisolone, mizoribine, and lisinopril was more effective in achieving earlier proteinuria remission and required a shorter duration of prednisolone exposure, with no significant difference in proteinuria recurrence compared with the previous regimen in children with severe cIgAN.
METHODS: Among 567 biopsy‑proven cIgAN cases treated between 1976 and 2022, 93 patients met the criteria for severe cIgAN. Of these, 77 received the previous regimen and 16 received the new regimen. Severe cIgAN was defined as diffuse mesangial proliferation and/or persistent heavy proteinuria (> 1 g/gCr). To adjust for baseline differences in proteinuria, eGFR, and C‑lesions, 1:1 propensity score matching was performed, yielding 15 matched pairs.
RESULTS: Baseline clinicopathological characteristics did not differ significantly between groups. Kaplan-Meier analysis showed that the new regimen was associated with a higher proteinuria remission rate during follow-up (log-rank p = 0.01) and a shorter time to remission (median 1.0 vs. 4.0 years, p = 0.03). Hematuria remission tended to be higher with the new regimen (80.0% vs. 46.7%). Proteinuria recurrence rates were comparable between groups.
CONCLUSIONS: The two‑year regimen of prednisolone, mizoribine, and lisinopril was more effective in achieving earlier proteinuria remission and required a shorter duration of prednisolone exposure, with no significant difference in proteinuria recurrence compared with the previous regimen in children with severe cIgAN.