Early initiation of tacrolimus or cyclophosphamide therapy for idiopathic membranous nephropathy with severe proteinuria.

Abstract:

BACKGROUND:Early initiation of therapy is warranted for patients with idiopathic membranous nephropathy (IMN) who have severe proteinuria. Therapy with tacrolimus (TAC) or intravenous cyclophosphamide (CYC) may be an option in treating such patients. METHODS:This prospective cohort study included patients with IMN whose daily proteinuria was greater than 6.0 g with 3-6 months observation of nonimmunosuppressive therapy. One cohort received prednisone combined with oral TAC (target trough blood level of 4-8 ng/mL) for 24 weeks. The other cohort received prednisone combined with intravenous CYC (750 mg/m2 body surface) every 2 weeks for the first 8 weeks and then once per 4 weeks for the next 16 weeks. RESULTS:Thirty patients met criteria for enrollment, and 25 patients completed therapy. The results of the 24-week therapeutic period were complete remission (CR) 4 patients (30.8%) on CYC and 8 patients (66.7%) on TAC; partial remission (PR) 7 patients (53.8%) on CYC and 3 patients (25%) on TAC; no response 2 patients (15.4%) on CYC and 1 patient (8.3%) on TAC. The percentages of remission (either PR or CR) by 4 and 8 weeks were significantly higher in TAC group than in CYC group (p

journal_name

J Nephrol

journal_title

Journal of nephrology

authors

Li X,Lv R,He Q,Li H,Du X,Lin W,Li Q,He X,Wang S,Chen J

subject

Has Abstract

pub_date

2008-07-01 00:00:00

pages

584-91

issue

4

eissn

1121-8428

issn

1724-6059

journal_volume

21

pub_type

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