Intravenous pulse cyclophosphamide and steroids induce immunological and clinical remission in New-incident and relapsing primary membranous nephropathy

Autor: Durga Kanigicherla, Patrick B. Hamilton, Krystyna Czapla, Paul Brenchley
Rok vydání: 2016
Předmět:
Male
medicine.medical_specialty
Nephrotic Syndrome
Time Factors
Cyclophosphamide
Subsequent Relapse
medicine.medical_treatment
Prednisolone
030232 urology & nephrology
Administration
Oral
030204 cardiovascular system & hematology
Gastroenterology
Glomerulonephritis
Membranous
Severity of Illness Index
End stage renal disease
03 medical and health sciences
0302 clinical medicine
Membranous nephropathy
Recurrence
Internal medicine
medicine
Humans
Prospective Studies
Glucocorticoids
Aged
Autoantibodies
Proteinuria
Cumulative dose
business.industry
Incidence
Receptors
Phospholipase A2
Remission Induction
Immunosuppression
General Medicine
Middle Aged
medicine.disease
Treatment Outcome
Nephrology
Pulse Therapy
Drug
Immunology
Administration
Intravenous
Female
medicine.symptom
business
Nephrotic syndrome
Immunosuppressive Agents
medicine.drug
Zdroj: Kanigicherla, D A K, Hamilton, P, Czapla, K & Brenchley, P E 2016, ' Intravenous Pulse cyclophosphamide and steroids induce immunological and clinical remission in New-incident and relapsing Primary Membranous Nephropathy ', Nephrology . https://doi.org/10.1111/nep.12955
ISSN: 1440-1797
DOI: 10.1111/nep.12955
Popis: AIM: Primary membranous nephropathy (PMN) is associated with progression to end stage renal disease in some patients. Standard immunosuppressive therapy with cyclical cyclophosphamide and corticosteroids can be associated with significant adverse effects. We aimed to assess immunological and clinical response with intravenous pulse cyclophosphamide and oral steroids in patients with severe nephrotic syndrome - in a prospective observational cohort study at our centre.METHODS: 17 consecutive patients (9 New-incident and 8 relapses) with severe nephrotic syndrome received intravenous pulse cyclophosphamide and daily oral steroids after failure to achieve remission with supportive therapy alone. Immunosuppressive therapy was discontinued at 6 months or earlier if proteinuria regressed to RESULTS: Dose of cyclophosphamide received was 5.4gm in New-incident patients and 4.2gm in patients with relapses. All 17 patients achieved partial remission within 6 months: proteinuria improved from 656 to 102mg/mmol at 6-months and 55mg/mmol at 12-months (p CONCLUSION: Monthly intravenous pulse cyclophosphamide with oral steroids induced immunological and clinical partial remission at significantly reduced cyclophosphamide and steroid doses in PMN.
Databáze: OpenAIRE
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