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Is Steroid Therapy Effective At Treating IgA Nephropathy?

Posted on Mon, 25 Sep 2017

Question: Hi
I am 51 yrs old male and suffering from Iga nephroparhy since 4 yrs
Presently on micardis 80 mg and omega 3 capsules
My bp is under control
My creatinine is rising from 1.4 to 1.8 in 3 years and proteinurea is 1 gm
Shall I start steroid therapy
If yes then what are the regimes
Thanks

Answered by Dr. Ravi Bansal (32 hours later)

Brief Answer:
Can use steroid

Detailed Answer:
hi,

if you have plenty of rbc in urine and urine protein more than one gram you may be benefited by steroids.

Generally steroids are started after ruling out any infection. and medicines dose is 1mg/ kg per day for 1 month and then taper.

but any immunosuppressive medication should be started under strict supervision of your doctor.

best wishes

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Ravi Bansal (2 days later)

What is your personal experience with this regimen
As in KDIGO GUIDELINES there r 2 types of regimes
One with pulse therapy with methyl prednisone 1 gm for 3 days on month 1,3,5 and maintenance with .5 mg/kg prednisone
Another one is 1mg/kg for 2 months prednisone followed by tapering doses for next 4 months
I would like to know ur personal experience with steroids in iga nephropathy as I am bit worried about side effects
Another point on which i want ur opinion is flu vaccine in iga nephropathy
I want to take influenza vaccine but can it trigger iga nephropathy
Regards

Answered by Dr. Ravi Bansal (13 hours later)

Brief Answer:
Less dose is better

Detailed Answer:
hi,

not all igA patients are treatd with steroids but if it is indicatrd like in high proteinuria i prefer lower dose of 1 mg/ kg as in decreases risk of infections.

vaccination with flu vaccine should not be done while on steroids as it is live vaccine. i dont think that vaccination will precipitate igA nephropathy.

best wishes.

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Ravi Bansal (23 hours later)

Does this low dose regimen is equally effective in your experience?

What is role of folic acid in reducing proteinurea
And if is indicated then in what dose

Answered by Dr. Ravi Bansal (10 hours later)

Brief Answer:
Yes low dose is good

Detailed Answer:
Hi,

I have a very good response with low dose regimen also. Folic Acid has no role in reducing proteinuria.

Regards

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Ravi Bansal (44 hours later)

Hi
Can you let me know low dose steroid regime in detail including doses , duration and patttern of tapering doses?
Regards

Answered by Dr. Ravi Bansal (26 hours later)

Brief Answer:
Depends on patient condition and response

Detailed Answer:
Hi,

you should start atleast with 1 mg/ kg/ day of prednisolone . but the dose , duration and tapering depends on the response of medication and any side effects which have to be examined every 15 days by your treating nephrologist. till there is response.

so there is no fixed shedule and it has to be determined by youf treatong doctor

best wishes

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Above answer was peer-reviewed by : Dr. Prasad