Individuals with high-risk immunoglobulin A nephropathy (IgAN) are often prescribed steroids to preserve kidney function. This treatment prevents or delays the need for dialysis or a kidney transplant. However, do steroids cause other adverse outcomes? Discover what one study found in IgAN patients taking steroids.* 

What They Did

Researchers at the University of New South Wales in Sydney, Australia recruited 503 participants with high-risk IgAN. To be considered high-risk, participants had to meet these requirements:

• Proteinuria ≥1g/day
• eGFR 20-120 mL/min/1.73m2 following ≥3 months of optimized background care, including Renin-angiotensin system (RAS) blockade

Participants were randomly assigned to take an oral steroid (methylprednisolone) or a placebo. Patients on the oral steroid were placed on an oral dose regimen protocol and either prescribed full-dose or reduced-dose, 0.58 or 0.27 respectively.

What they Found

With an average follow-up time of 4.2 years, patients assigned an oral steroid had a reduced risk in the primary outcomes measured, which were a 40% decline in kidney function or need for dialysis. This risk reduction was discovered in patients on both reduced-dose and full-dose steroids.

Serious adverse events, such as hospitalization and death, were also measured. While patients on a reduced-dose steroid did not have an increased risk, patients on a full-dose steroid more commonly experienced a serious adverse reaction compared to the placebo group.

What it Means

Steroids may reduce the risk of major kidney outcomes and kidney failure with high-risk IgAN. However, high-dose steroid therapy may increase the risk for serious adverse events. Physicians should prescribe high-dose steroids with caution and discuss the risks and benefits with each patient.

*ASN: Steroids Best Placebo in High-Risk IgA Nephropathy. (2021, November 16). Consumer Health News | HealthDay. https://consumer.healthday.com/steroids-cut-risk-of-kidney-failure-with-iga-nephropathy-2655515111.html