Clinical effect of tacrolimus combined with glucocorticoid in the treatment of IgA nephropathy in children.
- Author:
Jian-Jiang ZHANG
1
;
Qin WANG
;
Wen-Jie DOU
;
Li-Min JIA
;
Li ZHANG
;
Yi-Bo CHENG
;
Wen-Xiu TAN
;
Fan ZHAO
Author Information
1. Department of Pediatrics, First Affiliated Hospital of Zhengzhou University, Clinical Center of Pediatric Nephrology of Henan Province, Zhengzhou 450052, China. zhangjianjiang10@163.com.
- Publication Type:Journal Article
- MeSH:
Child;
Drug Therapy, Combination;
Glomerulonephritis, IGA;
drug therapy;
Glucocorticoids;
therapeutic use;
Humans;
Immunosuppressive Agents;
Mycophenolic Acid;
Retrospective Studies;
Tacrolimus;
therapeutic use
- From:
Chinese Journal of Contemporary Pediatrics
2019;21(3):265-270
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To study the clinical effect and safety of tacrolimus (TAC) combined with glucocorticoid (GC) versus mycophenolate mofetil (MMF) combined with GC in the treatment of primary IgA nephropathy (IgAN) in children.
METHODS:A retrospective analysis was performed for the clinical data of children with primary IgAN confirmed by renal pathology between January 2012 and December 2017. These children were divided into TAC group and MMF group according to the treatment regimen. Their clinical data before treatment and at 1, 3, and 6 months of treatment were collected, and the remission status of IgAN and adverse reactions were compared between the two groups.
RESULTS:A total of 43 children who met the inclusion criteria were enrolled, with 15 children in the TAC group and 28 children in the MMF group. At 1 month of treatment, there was no significant difference in the remission status between the two groups (P>0.05). At 3 and 6 months of treatment, the TAC group had a significantly better remission status than the MMF group (P<0.05). At 1 month of treatment, the TAC group had higher serum albumin levels than the MMF group (P<0.05). Both groups had a significant increase in serum albumin levels at each time point after treatment (P<0.0083) and a significant increase in the glomerular filtration rate (GFR) at 3 and 6 months of treatment (P<0.0083). There was no significant difference in the overall incidence rate of adverse reactions between the two groups (P>0.05), but fungal infection was observed in one child from the TAC group.
CONCLUSIONS:TAC combined with GC can effectively reduce urinary protein in children with primary IgAN, and it has a better short-term clinical effect than MMF combined with GC, with good safety.
