| Autor: |
Artan, Ayşe Serra, Mirioğlu, Şafak, Hocaoğlu, Rabia Hacer, Turgutalp, Kenan, Güllülü Boz, Saide Elif, Eren, Necmi, Dinçer, Mevlüt Tamer, Uzun, Sami, Şahin, Gülizar, Kutlay, Sim, Cevher, Şimal Köksal, Dheir, Hamad, Yılmaz, Mürvet, Baştürk, Taner, Tatar, Erhan, Kurultak, İlhan, Öztürk, Ramazan, Arıkan, Hakkı, Yadigar, Serap, Tunca, Onur |
| Předmět: |
|
| Zdroj: |
BMC Nephrology; 10/1/2024, Vol. 25 Issue 1, p1-10, 10p |
| Abstrakt: |
Background: We evaluated the efficacy of different immunosuppressive regimens in patients with primary membranous nephropathy in a large national cohort. Methods: In this registry study, 558 patients from 47 centers who were treated with at least one immunosuppressive agent and had adequate follow-up data were included. Primary outcome was defined as complete (CR) or partial remission (PR). Secondary composite outcome was at least a 50% reduction in estimated glomerular filtration (eGFR), initiation of kidney replacement therapies, development of stage 5 chronic kidney disease, or death. Results: Median age at diagnosis was 48 (IQR: 37–57) years, and 358 (64.2%) were male. Patients were followed for a median of 24 (IQR: 12–60) months. Calcineurin inhibitors (CNIs) with or without glucocorticoids were the most commonly used regimen (43.4%), followed by glucocorticoids and cyclophosphamide (GC-CYC) (39.6%), glucocorticoid monotherapy (25.8%), and rituximab (RTX) (9.1%). Overall remission rate was 66.1% (CR 26.7%, PR 39.4%), and 59 (10.6%) patients reached secondary composite outcome. Multivariate logistic regression showed that baseline eGFR (OR 1.011, 95% CI: 1.003–1.019, p = 0.007), serum albumin (OR 1.682, 95% CI: 1.269–2.231, p < 0.001), and use of RTX (OR 0.296, 95% CI: 0.157–0.557, p < 0.001) were associated with remission rates; whereas only lower baseline hemoglobin was significantly associated with secondary composite outcome (OR: 0.843, 95% CI: 0.715–0.993, p = 0.041). CYC use was significantly associated with higher remission (OR 1.534, 95% CI: 1.027–2.290, p = 0.036). Conclusions: Higher baseline eGFR and serum albumin levels correlated with increased remission rates. Remission rates were lower in patients treated with RTX, while those on GC-CYC showed higher rates of remission. Due to the study's retrospective nature and multiple treatments used, caution is warranted in interpreting these findings. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
|
Full text from SpringerLink