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Corticosteroids and ciclosporin A in idiopathic membranous nephropathy: higher remission rates of nephrotic syndrome and less adverse reactions than after traditional treatment with cytotoxic drugs.
- Source :
-
American journal of nephrology [Am J Nephrol] 2007; Vol. 27 (3), pp. 226-31. Date of Electronic Publication: 2007 Mar 27. - Publication Year :
- 2007
-
Abstract
- Background/aim: Idiopathic membranous nephropathy, the most common cause of nephrotic syndrome in adults, has been traditionally treated with corticosteroids and cytotoxic drugs. Ciclosporin A (CsA) is used in resistant cases, but also as a first-line treatment, due to the serious side effects of cytotoxic drugs. In this study, the remission rates of nephrotic syndrome and the incidence of side effects of corticosteroids and low CsA doses are compared with those after treatment with cytotoxic drugs.<br />Methods: Seventy-seven nephrotic patients with well-preserved renal function who were treated with methylprednisolone and CsA (n = 46) or cytotoxic drugs (n = 31) were studied. The effects of treatments were estimated on the basis of remission rates of nephrotic syndrome and preservation of the renal function.<br />Results: Remission (complete or partial) of nephrotic syndrome was observed in 85% of the patients treated with CsA and in 55% of the patients treated with cytotoxic drugs (p < 0.01). Deterioration of the renal function, more common in patients with multiple relapses and interstitial fibrosis, was observed in 26 and 23% of the patients, respectively (p = NS). Serious side effects and discontinuation of treatment were more frequent in patients treated with cytotoxic drugs (10 vs. 4%).<br />Conclusion: The combination of corticosteroids with CsA represents a better regimen for patients having idiopathic membranous nephropathy, since it is associated with higher remission rates of nephrotic syndrome and less severe side effects than corticosteroids and cytotoxic drugs.<br /> (2007 S. Karger AG, Basel)
- Subjects :
- Adrenal Cortex Hormones adverse effects
Adult
Aged
Cyclosporine administration & dosage
Cyclosporine adverse effects
Cytotoxins adverse effects
Cytotoxins therapeutic use
Drug Therapy, Combination
Female
Humans
Immunosuppressive Agents administration & dosage
Immunosuppressive Agents adverse effects
Kidney Function Tests
Male
Middle Aged
Recurrence
Remission Induction
Retrospective Studies
Treatment Outcome
Adrenal Cortex Hormones therapeutic use
Cyclosporine therapeutic use
Glomerulonephritis, Membranous drug therapy
Immunosuppressive Agents therapeutic use
Nephrotic Syndrome drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1421-9670
- Volume :
- 27
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- American journal of nephrology
- Publication Type :
- Academic Journal
- Accession number :
- 17389782
- Full Text :
- https://doi.org/10.1159/000101367