Clinical efficacy of mycophenolate mofetil plus low-dose glucocorticoid for IgA nephropathy with crescent formation

Objective  To explore the efficacy and safety of mycophenolate mofetil (MMF) plus low-dose glucocorticoid for IgA nephropathy (IgAN) with crescent formation.

Methods  From September 2019 to December 2021, 58 IgAN patients with crescent formation diagnosed by renal biopsy were selected as research subjects. They were divided into two groups of combination (A, n=37) and control (B, n=21) according to therapy protocol. Group B received a conventional dose of glucocorticoid while group A had MMF plus low-dose glucocorticoid. Clinical efficacy, related parameters (24h urinary total protein, urinary red blood cell (RBC), serum creatinine, urea nitrogen, uric acid & albumin) levels, adverse reaction (acne, full moon face, skin purplish lines, ecchymosis, gastrointestinal reaction, infection & hepatic injury) were compared between two groups.

Results  Overall effective rate of combination group was higher than that of control group with statistical difference (94.6% vs 71.4%, P＜0.05). After 6-month treatment, the levels of 24h urinary total protein, urinary RBC, serum creatinine and urea nitrogen declined in combination group than those in control group and the level of albumin in combination group was higher than that in control group with statistical difference (P＜0.05). The incidence of adverse reaction was 37.8% and 33.3% in combination and control groups. And the prevalence of infection and hepatic injury was slightly higher in combination group than those in control group. And inter-group difference was not statistically significant (P＞0.05).

Conclusions  MMF plus low-dose glucocorticoid have an excellent efficacy for IgAN with crescent formation. It improves renal function, reduces urinary protein and ensures the safety of medication with minimal adverse reaction.