The study concluded that such therapy was effective for inducing remission and safe for elderly patients with membranous nephropathy. For the treatment of steroid-resistant cases with FSGS, a previous RCT demonstrated that
immunosuppressives combined with low-dose corticosteroid was effective. Another cohort study reported that corticosteroid monotherapy was effective for inducing remission in patients aged ≥66 years with FSGS. Considering these results, the administration of immunosuppressives combined with corticosteroid is recommended for elderly patients with steroid-resistant idiopathic membranous nephropathy in order to induce remission. For the treatment selleck chemical of FSGS, corticosteroid monotherapy is recommended as the first-line treatment and immunosuppressives combined with corticosteroid should C646 concentration be tried in elderly patients with steroid-resistant FSGS. Immunosuppressive therapy for elderly patients should be undertaken carefully since the elderly are particularly prone to the adverse effects and infectious complications of immunosuppression. Conservative therapy with RAS inhibitors or diuretics is recommended
when the patients are highly immunocompromised or complicated. Bibliography 1. Perna A, et al. Am J Kidney Dis. 2004;44:385–401. (Level 1) 2. Ponticelli C, et al. J Am Soc Nephrol. 1998;9:444–9:4. (Level 2) 3. Jha V, et al. J Am Soc 4-Aminobutyrate aminotransferase Nephrol. 2007;18:1899–18:1. (Level 2) 4. Shiiki H, et al. Kidney Int. 2004;65:1400–7. (Level 4) 5. Passerini P, et al. Nephrol Dial Transplant. 1993;8:1321–5. (Level 4) 6. Cattran DC, et al. Kidney Int. 1999;56:2220–6. (Level 2) 7. Nagai R, et al. Clin Nephrol. 1994;42:18–21. (Level 4) Is treatment with corticosteroid recommended for elderly patients with IgAN to suppress the progression of renal
dysfunction? The current cumulative evidence suggests that corticosteroid has significant effects on protecting renal function and reducing proteinuria in patients with IgAN, but whether or not it is also effective for elderly patients remains unclear. When the histological diagnosis of IgAN was established, poor prognosis indices, such as systolic high blood pressure, severe proteinuria, decreased Ccr, and severely impaired histology, were more Selleck AZD1152-HQPA commonly present in elderly patients aged over 50 years than those under 50 years. Therefore, treatment with corticosteroid is recommended to slow the progression of renal dysfunction in elderly patients with IgAN. Bibliography 1. Cheng J, et al. Am J Nephrol. 2009;30:315–22. (Level 4) 2. Zhou YH, et al. PLoS One. 2011;6:e18788. (Level 4) 3. Frimat L, et al. Nephrol Dial Transplant. 1996;11:1043–7.