Immunosuppressive treatment results in patients with primary IgA nephropathy in Turkiye; the data from TSN-GOLD working group
Background Immunoglobulin A (IgA) nephropathy (IgAN) treatment consists of maximal supportive care and, for high-risk individuals, immunosuppressive treatment (IST). There are conflicting results regarding IST. Therefore, we aimed to investigate IST results among IgAN patients in Turkiye.Method The...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Taylor & Francis Group
2024-12-01
|
| Series: | Renal Failure |
| Subjects: | |
| Online Access: | https://www.tandfonline.com/doi/10.1080/0886022X.2024.2341787 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832591091825639424 |
|---|---|
| author | Aysegul Oruc Abdullah Sumnu Aydın Turkmen Taner Basturk Egemen Cebeci Kenan Turgutalp Hakkı Cetinkaya Müge Uzerk Kibar Nurhan Seyahi Erhan Tatar Metin Ergul Ülver Derici Mehmet Deniz Aylı Musa Pınar Betül Bakar Rümeyza Kazancıoglu Abdülmecit Yıldız Ahmet Burak Dirim Zülfükar Yılmaz Kültigin Turkmen Onur Tunca Mehmet Koc Sim Kutlay Hasan Micozkadıoglu Alper Azak Burcu Boztepe Sedat Ustundag Seda Şafak Ozturk Abdulkadir Unsal Serhat Karadag Gülizar Sahin Ezgi Coşgun Yenigun Necmi Eren Mustafa Gullulu Meltem Gursu Savaş Ozturk |
| author_facet | Aysegul Oruc Abdullah Sumnu Aydın Turkmen Taner Basturk Egemen Cebeci Kenan Turgutalp Hakkı Cetinkaya Müge Uzerk Kibar Nurhan Seyahi Erhan Tatar Metin Ergul Ülver Derici Mehmet Deniz Aylı Musa Pınar Betül Bakar Rümeyza Kazancıoglu Abdülmecit Yıldız Ahmet Burak Dirim Zülfükar Yılmaz Kültigin Turkmen Onur Tunca Mehmet Koc Sim Kutlay Hasan Micozkadıoglu Alper Azak Burcu Boztepe Sedat Ustundag Seda Şafak Ozturk Abdulkadir Unsal Serhat Karadag Gülizar Sahin Ezgi Coşgun Yenigun Necmi Eren Mustafa Gullulu Meltem Gursu Savaş Ozturk |
| author_sort | Aysegul Oruc |
| collection | DOAJ |
| description | Background Immunoglobulin A (IgA) nephropathy (IgAN) treatment consists of maximal supportive care and, for high-risk individuals, immunosuppressive treatment (IST). There are conflicting results regarding IST. Therefore, we aimed to investigate IST results among IgAN patients in Turkiye.Method The data of 1656 IgAN patients in the Primary Glomerular Diseases Study of the Turkish Society of Nephrology Glomerular Diseases Study Group were analyzed. A total of 408 primary IgAN patients treated with IST (65.4% male, mean age 38.4 ± 12.5 years, follow-up 30 (3–218) months) were included and divided into two groups according to treatment protocols (isolated corticosteroid [CS] 70.6% and combined IST 29.4%). Treatment responses, associated factors were analyzed.Results Remission (66.7% partial, 33.7% complete) was achieved in 74.7% of patients. Baseline systolic blood pressure, mean arterial pressure, and proteinuria levels were lower in responsives. Remission was achieved at significantly higher rates in the CS group (78% vs. 66.7%, p = 0.016). Partial remission was the prominent remission type. The remission rate was significantly higher among patients with segmental sclerosis compared to those without (60.4% vs. 49%, p = 0.047). In the multivariate analysis, MEST-C S1 (HR 1.43, 95% CI 1.08–1.89, p = 0.013), MEST-C T1 (HR 0.68, 95% CI 0.51–0.91, p = 0.008) and combined IST (HR 0.66, 95% CI 0.49–0.91, p = 0.009) were found to be significant regarding remission.Conclusion CS can significantly improve remission in high-risk Turkish IgAN patients, despite the reliance on non-quantitative endpoints for favorable renal outcomes. Key predictors of remission include baseline proteinuria and specific histological markers. It is crucial to carefully weigh the risks and benefits of immunosuppressive therapy for these patients. |
| format | Article |
| id | doaj-art-4a4afe6013ca4859916736e8e7ef82c4 |
| institution | Kabale University |
| issn | 0886-022X 1525-6049 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Renal Failure |
| spelling | doaj-art-4a4afe6013ca4859916736e8e7ef82c42025-01-23T04:17:49ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492024-12-0146110.1080/0886022X.2024.2341787Immunosuppressive treatment results in patients with primary IgA nephropathy in Turkiye; the data from TSN-GOLD working groupAysegul Oruc0Abdullah Sumnu1Aydın Turkmen2Taner Basturk3Egemen Cebeci4Kenan Turgutalp5Hakkı Cetinkaya6Müge Uzerk Kibar7Nurhan Seyahi8Erhan Tatar9Metin Ergul10Ülver Derici11Mehmet Deniz Aylı12Musa Pınar13Betül Bakar14Rümeyza Kazancıoglu15Abdülmecit Yıldız16Ahmet Burak Dirim17Zülfükar Yılmaz18Kültigin Turkmen19Onur Tunca20Mehmet Koc21Sim Kutlay22Hasan Micozkadıoglu23Alper Azak24Burcu Boztepe25Sedat Ustundag26Seda Şafak Ozturk27Abdulkadir Unsal28Serhat Karadag29Gülizar Sahin30Ezgi Coşgun Yenigun31Necmi Eren32Mustafa Gullulu33Meltem Gursu34Savaş Ozturk35Department of Nephrology, Bursa Uludag University Faculty of Medicine, Bursa, TurkiyeDepartment of Nephrology, Medipol University Faculty of Medicine, Istanbul, TurkiyeDepartment of Nephrology, Istanbul University Faculty of Medicine, Istanbul, TurkiyeDepartment of Nephrology, University of Health Sciences, Etfal Hamidiye Training and Research Hospital, Istanbul, TurkiyeDepartment of Nephrology, Istanbul Provincial Directorate of Health Istanbul Haseki Training and Research Hospital, Istanbul, TurkiyeDepartment of Nephrology, Mersin University Faculty of Medicine, Training and Educational Hospital, Mersin, TurkiyeDepartment of Nephrology, University of Health Sciences, Sultan 2. Abdülhamid Han Training and Research Hospital, Istanbul, TurkiyeDepartment of Nephrology, Health Ministry of Turkiye Republic Ankara Bilkent City Hospital, Ankara, TurkiyeDepartment of Nephrology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, TurkiyeDepartment of Nephrology, Izmir Provincial Directorate of Health Bozyaka Education and Research Hospital, Izmir, TurkiyeDepartment of Nephrology, Faculty of Medicine, Kocaeli University, Kocaeli, TurkiyeDepartment of Nephrology, Faculty of Medicine, Gazi University, Ankara, TurkiyeDepartment of Nephrology, Mınıstry Of Health Dıskapı Yıldırım Beyazıt Traınıng And Research Hospıtal, Ankara, TurkiyeDepartment of Nephrology, Faculty of Medicine, Sakarya University, Sakarya, TurkiyeDepartment of Nephrology, Ankara Provincial Health Directorate Ankara Training and Research Hospital, Ankara, TurkiyeDepartment of Nephrology, Faculty of Medicine, Bezmialem Vakif Univeristy, Istanbul, TurkiyeDepartment of Nephrology, Bursa Uludag University Faculty of Medicine, Bursa, TurkiyeDepartment of Nephrology, Istanbul Provincial Health Directorate ˙Istanbul Bakirköy Dr. Sadi Konuk Education And Research Hospital, Istanbul, TurkiyeDepartment of Nephrology, Dicle University Faculty of Medicine, Diyarbakır, TurkiyeDepartment of Nephrology, Faculty of Medicine Hospital, Necmettin Erbakan University Meram, Konya, TurkiyeDepartment of Nephrology, Faculty of Medicine, Afyonkarahisar University of Health Sciences, Afyonkarahisar, TurkiyeDepartment of Nephrology, Faculty of Medicine, Marmara University, Istanbul, TurkiyeDepartment of Nephrology, Faculty of Medicine, Ankara University, Ankara, TurkiyeDepartment of Nephrology, Baskent University Faculty of Medicine, Dr. Turgut Noyan Adana Application and Research Hospital, Adana, TurkiyeDepartment of Nephrology, Balikesir Provincial Health Directorate Atatürk City Hospital, Balıkesir, TurkiyeDepartment of Nephrology, Istanbul Provincial Health Directorate Haydarpasa Numune Traınıng And Research Hospıtal, Istanbul, TurkiyeDepartment of Nephrology, Faculty of Medicine, Trakya University, Edirne, TurkiyeDepartment of Nephrology, Istanbul University Faculty of Medicine, Istanbul, TurkiyeDepartment of Nephrology, University of Health Sciences, Etfal Hamidiye Training and Research Hospital, Istanbul, TurkiyeDepartment of Nephrology, Istanbul Provincial Directorate of Health Istanbul Haseki Training and Research Hospital, Istanbul, TurkiyeDepartment of Nephrology, University of Health Sciences, Sultan 2. Abdülhamid Han Training and Research Hospital, Istanbul, TurkiyeDepartment of Nephrology, Ankara Provincial Health Directorate Ankara Training and Research Hospital, Ankara, TurkiyeDepartment of Nephrology, Faculty of Medicine, Kocaeli University, Kocaeli, TurkiyeDepartment of Nephrology, Bursa Uludag University Faculty of Medicine, Bursa, TurkiyeDepartment of Nephrology, Faculty of Medicine, Bezmialem Vakif Univeristy, Istanbul, TurkiyeDepartment of Nephrology, Istanbul University Faculty of Medicine, Istanbul, TurkiyeBackground Immunoglobulin A (IgA) nephropathy (IgAN) treatment consists of maximal supportive care and, for high-risk individuals, immunosuppressive treatment (IST). There are conflicting results regarding IST. Therefore, we aimed to investigate IST results among IgAN patients in Turkiye.Method The data of 1656 IgAN patients in the Primary Glomerular Diseases Study of the Turkish Society of Nephrology Glomerular Diseases Study Group were analyzed. A total of 408 primary IgAN patients treated with IST (65.4% male, mean age 38.4 ± 12.5 years, follow-up 30 (3–218) months) were included and divided into two groups according to treatment protocols (isolated corticosteroid [CS] 70.6% and combined IST 29.4%). Treatment responses, associated factors were analyzed.Results Remission (66.7% partial, 33.7% complete) was achieved in 74.7% of patients. Baseline systolic blood pressure, mean arterial pressure, and proteinuria levels were lower in responsives. Remission was achieved at significantly higher rates in the CS group (78% vs. 66.7%, p = 0.016). Partial remission was the prominent remission type. The remission rate was significantly higher among patients with segmental sclerosis compared to those without (60.4% vs. 49%, p = 0.047). In the multivariate analysis, MEST-C S1 (HR 1.43, 95% CI 1.08–1.89, p = 0.013), MEST-C T1 (HR 0.68, 95% CI 0.51–0.91, p = 0.008) and combined IST (HR 0.66, 95% CI 0.49–0.91, p = 0.009) were found to be significant regarding remission.Conclusion CS can significantly improve remission in high-risk Turkish IgAN patients, despite the reliance on non-quantitative endpoints for favorable renal outcomes. Key predictors of remission include baseline proteinuria and specific histological markers. It is crucial to carefully weigh the risks and benefits of immunosuppressive therapy for these patients.https://www.tandfonline.com/doi/10.1080/0886022X.2024.2341787IgA nephropathyimmunosuppressive treatmentTurkiyeremissionoutcome |
| spellingShingle | Aysegul Oruc Abdullah Sumnu Aydın Turkmen Taner Basturk Egemen Cebeci Kenan Turgutalp Hakkı Cetinkaya Müge Uzerk Kibar Nurhan Seyahi Erhan Tatar Metin Ergul Ülver Derici Mehmet Deniz Aylı Musa Pınar Betül Bakar Rümeyza Kazancıoglu Abdülmecit Yıldız Ahmet Burak Dirim Zülfükar Yılmaz Kültigin Turkmen Onur Tunca Mehmet Koc Sim Kutlay Hasan Micozkadıoglu Alper Azak Burcu Boztepe Sedat Ustundag Seda Şafak Ozturk Abdulkadir Unsal Serhat Karadag Gülizar Sahin Ezgi Coşgun Yenigun Necmi Eren Mustafa Gullulu Meltem Gursu Savaş Ozturk Immunosuppressive treatment results in patients with primary IgA nephropathy in Turkiye; the data from TSN-GOLD working group Renal Failure IgA nephropathy immunosuppressive treatment Turkiye remission outcome |
| title | Immunosuppressive treatment results in patients with primary IgA nephropathy in Turkiye; the data from TSN-GOLD working group |
| title_full | Immunosuppressive treatment results in patients with primary IgA nephropathy in Turkiye; the data from TSN-GOLD working group |
| title_fullStr | Immunosuppressive treatment results in patients with primary IgA nephropathy in Turkiye; the data from TSN-GOLD working group |
| title_full_unstemmed | Immunosuppressive treatment results in patients with primary IgA nephropathy in Turkiye; the data from TSN-GOLD working group |
| title_short | Immunosuppressive treatment results in patients with primary IgA nephropathy in Turkiye; the data from TSN-GOLD working group |
| title_sort | immunosuppressive treatment results in patients with primary iga nephropathy in turkiye the data from tsn gold working group |
| topic | IgA nephropathy immunosuppressive treatment Turkiye remission outcome |
| url | https://www.tandfonline.com/doi/10.1080/0886022X.2024.2341787 |
| work_keys_str_mv | AT ayseguloruc immunosuppressivetreatmentresultsinpatientswithprimaryiganephropathyinturkiyethedatafromtsngoldworkinggroup AT abdullahsumnu immunosuppressivetreatmentresultsinpatientswithprimaryiganephropathyinturkiyethedatafromtsngoldworkinggroup AT aydınturkmen immunosuppressivetreatmentresultsinpatientswithprimaryiganephropathyinturkiyethedatafromtsngoldworkinggroup AT tanerbasturk immunosuppressivetreatmentresultsinpatientswithprimaryiganephropathyinturkiyethedatafromtsngoldworkinggroup AT egemencebeci immunosuppressivetreatmentresultsinpatientswithprimaryiganephropathyinturkiyethedatafromtsngoldworkinggroup AT kenanturgutalp immunosuppressivetreatmentresultsinpatientswithprimaryiganephropathyinturkiyethedatafromtsngoldworkinggroup AT hakkıcetinkaya immunosuppressivetreatmentresultsinpatientswithprimaryiganephropathyinturkiyethedatafromtsngoldworkinggroup AT mugeuzerkkibar immunosuppressivetreatmentresultsinpatientswithprimaryiganephropathyinturkiyethedatafromtsngoldworkinggroup AT nurhanseyahi immunosuppressivetreatmentresultsinpatientswithprimaryiganephropathyinturkiyethedatafromtsngoldworkinggroup AT erhantatar immunosuppressivetreatmentresultsinpatientswithprimaryiganephropathyinturkiyethedatafromtsngoldworkinggroup AT metinergul immunosuppressivetreatmentresultsinpatientswithprimaryiganephropathyinturkiyethedatafromtsngoldworkinggroup AT ulverderici immunosuppressivetreatmentresultsinpatientswithprimaryiganephropathyinturkiyethedatafromtsngoldworkinggroup AT mehmetdenizaylı immunosuppressivetreatmentresultsinpatientswithprimaryiganephropathyinturkiyethedatafromtsngoldworkinggroup AT musapınar immunosuppressivetreatmentresultsinpatientswithprimaryiganephropathyinturkiyethedatafromtsngoldworkinggroup AT betulbakar immunosuppressivetreatmentresultsinpatientswithprimaryiganephropathyinturkiyethedatafromtsngoldworkinggroup AT rumeyzakazancıoglu immunosuppressivetreatmentresultsinpatientswithprimaryiganephropathyinturkiyethedatafromtsngoldworkinggroup AT abdulmecityıldız immunosuppressivetreatmentresultsinpatientswithprimaryiganephropathyinturkiyethedatafromtsngoldworkinggroup AT ahmetburakdirim immunosuppressivetreatmentresultsinpatientswithprimaryiganephropathyinturkiyethedatafromtsngoldworkinggroup AT zulfukaryılmaz immunosuppressivetreatmentresultsinpatientswithprimaryiganephropathyinturkiyethedatafromtsngoldworkinggroup AT kultiginturkmen immunosuppressivetreatmentresultsinpatientswithprimaryiganephropathyinturkiyethedatafromtsngoldworkinggroup AT onurtunca immunosuppressivetreatmentresultsinpatientswithprimaryiganephropathyinturkiyethedatafromtsngoldworkinggroup AT mehmetkoc immunosuppressivetreatmentresultsinpatientswithprimaryiganephropathyinturkiyethedatafromtsngoldworkinggroup AT simkutlay immunosuppressivetreatmentresultsinpatientswithprimaryiganephropathyinturkiyethedatafromtsngoldworkinggroup AT hasanmicozkadıoglu immunosuppressivetreatmentresultsinpatientswithprimaryiganephropathyinturkiyethedatafromtsngoldworkinggroup AT alperazak immunosuppressivetreatmentresultsinpatientswithprimaryiganephropathyinturkiyethedatafromtsngoldworkinggroup AT burcuboztepe immunosuppressivetreatmentresultsinpatientswithprimaryiganephropathyinturkiyethedatafromtsngoldworkinggroup AT sedatustundag immunosuppressivetreatmentresultsinpatientswithprimaryiganephropathyinturkiyethedatafromtsngoldworkinggroup AT sedasafakozturk immunosuppressivetreatmentresultsinpatientswithprimaryiganephropathyinturkiyethedatafromtsngoldworkinggroup AT abdulkadirunsal immunosuppressivetreatmentresultsinpatientswithprimaryiganephropathyinturkiyethedatafromtsngoldworkinggroup AT serhatkaradag immunosuppressivetreatmentresultsinpatientswithprimaryiganephropathyinturkiyethedatafromtsngoldworkinggroup AT gulizarsahin immunosuppressivetreatmentresultsinpatientswithprimaryiganephropathyinturkiyethedatafromtsngoldworkinggroup AT ezgicosgunyenigun immunosuppressivetreatmentresultsinpatientswithprimaryiganephropathyinturkiyethedatafromtsngoldworkinggroup AT necmieren immunosuppressivetreatmentresultsinpatientswithprimaryiganephropathyinturkiyethedatafromtsngoldworkinggroup AT mustafagullulu immunosuppressivetreatmentresultsinpatientswithprimaryiganephropathyinturkiyethedatafromtsngoldworkinggroup AT meltemgursu immunosuppressivetreatmentresultsinpatientswithprimaryiganephropathyinturkiyethedatafromtsngoldworkinggroup AT savasozturk immunosuppressivetreatmentresultsinpatientswithprimaryiganephropathyinturkiyethedatafromtsngoldworkinggroup |