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Steroid therapy in children with IgA nephropathy

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Abstract

IgA nephropathy (IgAN) is one the most common primary glomerulonephritis in children and adolescents worldwide, with 20% of children developing end-stage kidney disease (ESKD) within 20 years of diagnosis. There is a need for treatment guidelines, especially for steroids in children with primary IgAN, since the STOP-IgA trial casts doubts on the use of steroids in adults with intermediate risk. Pediatricians are prone to prescribe steroids in addition to renin–angiotensin system blockade (RASB) when proteinuria is > 0.5 g/l, eGFR deteriorates < 70 ml/min/1.73 m2, or when a biopsy sample shows glomerular inflammation. Lack of randomized controlled trials (RCTs) in children with IgAN has led to an absence of consensus on the use of immunosuppressive agents in the treatment of progressive IgAN. This literature review evaluates the available evidence on steroid treatment in children with IgAN.

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Authors and Affiliations

  1. Pediatric Department of Nephrology and Transplantation, Assistance Publique-Hôpitaux de Paris, Hôpital Robert-Debré, Paris, France

    Alexandra Cambier, Georges Deschenes, Anne Couderc & Julien Hogan

  2. Pediatric Department of Nephrology and Transplantation, Assistance Publique-Hôpitaux de Paris, Hôpital Necker, Paris, France

    Olivia Boyer

  3. Université Paris Diderot, Faculté de Médecine, Site Xavier Bichat, INSERM U1149 & CNRS ERL8252, Centre de Recherche sur l’Inflammation, Paris, France

    James Gleeson

  4. Department of Nephrology, Transplantation and Emergency, Assistance Publique-Hôpitaux de Marseille, Hôpital de la Conception, Marseille, France

    Thomas Robert

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  1. Alexandra Cambier
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Cambier, A., Boyer, O., Deschenes, G. et al. Steroid therapy in children with IgA nephropathy. Pediatr Nephrol 35, 359–366 (2020). https://doi.org/10.1007/s00467-018-4189-7

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