Clinical effect of tacrolimus combined with glucocorticoid in the treatment of IgA nephropathy in children

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 confrmed 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 signifcant difference in the remission status between the two groups (P > 0.05). At 3 and 6 months of treatment, the TAC group had a signifcantly 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 signifcant increase in serum albumin levels at each time point after treatment (P < 0.0083) and a signifcant increase in the glomerular fltration rate (GFR) at 3 and 6 months of treatment (P < 0.0083). There was no signifcant 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.