Long-term results of a randomized controlled trial in childhood XXXX .

@entity1 @entity8 @entity1310 @entity500 @entity1229 @entity4341 @entity7622 @entity617 @entity454
BACKGROUND AND OBJECTIVES: @entity1 with @entity8 showing diffuse (>80%) mesangial proliferation are at high risk for @entity454 ( @entity454 ). A previous controlled trial showed that combination therapy consisting of @entity617 , @entity500 , heparin- @entity1229 , and @entity4341 early in the course of disease reduces @entity8 and prevents the progression of sclerosed glomeruli. The objective of this study was to evaluate the long-term effectiveness of combination therapy in @entity1 with @entity8 showing @entity7622 . DESIGN, SETTING, @entity1 , _ MEASUREMENTS: A secondary analysis of a multicenter, randomized, controlled trial involving 78 @entity1 with @entity8 who received either 2-year combination therapy or heparin- @entity1229 and dipyridamole (control) therapy was conducted. RESULTS: The median duration of observation was 10 years (range, 0.5 to 18). Two of 40 @entity1 (5%) who received combination therapy and five of 34 @entity1 (14.7%) who received control therapy developed @entity454 . A Kaplan-Meier plot of renal survival showed that the outcomes of @entity1 in the combined therapy group were better than those in the control therapy group (log-rank P = 0.03). The 10-year renal survival probability of each group was 97.1% (95% confidence interval, 81.4 to 99.6%) and 84.8% (95% confidence interval, 55.4 to 95.5%), respectively. The Cox proportional hazards model showed that the 2-year combination therapy was significantly associated with renal survival in both univariate and multivariate analyses. CONCLUSIONS: Two-year combination therapy not only ameliorated the activity of the acute phase of @entity1310 but also improved the long-term outcome of severe childhood @entity8 .
