[Steroid and cyclosporine therapy in idiopathic membranous nephropathy: monocentric experience and literature review]

Federica Zotta, Enrico Di Stasio, Andrea Manzione, Nicola Pirozzi, Antonella Stoppacciaro, Paolo Menè

Risultato della ricerca: Contributo in rivistaArticolo in rivistapeer review

Abstract

Abstract INTRODUCTION: Immunosuppressive treatment of patients with idiopathic membranous nephropathy (IMN) is debated due to its possible side effects. The 2012 KDIGO guidelines suggest alkylating agents as first choice therapy. The aim of the study is to retrospectively evaluate the induction and maintenance of clinical remission in patients with histological diagnosis of IMN undergoing steroid and/or cyclosporine therapy at the Nephrology Unit of the Sant'Andrea Hospital in Rome. MATERIALS AND METHODS: Therapy A (conservative) was reserved to low-risk patients. 8 medium and high risk patients were induced by Therapy B (Prednisone 1 mg / kg ≤12-16 weeks plus 8 weeks withdrawal); 6 patients by Therapy C (Prednisone 1 mg /kg ≥20-24 weeks plus 8 week withdrawal) and, finally, 6 steroid-resistent patients by Therapy D (steroid withdrawal + cyclosporine 3-5 mg / kg for 2 years). RESULTS: Complete remission was observed in 37.5% of patients in Therapy B, in 83.3% of patients in Therapy C and in 66.6% of patients in Therapy D. Patients in group B relapsed more frequently than patients in the other groups. Side effects were irrelevant. CONCLUSIONS: In view of the potential cytotoxicity of alkylating agents, steroids are a valid alternative in inducing and maintaining clinical remission over time, when administered with a more aggressive induction scheme. In cases of steroid resistance or rapid relapse, cyclosporine is a valid alternative to alkylating agents.
Titolo tradotto del contributo[Autom. eng. transl.] [Steroid and cyclosporine therapy in idiopathic membranous nephropathy: monocentric experience and literature review]
Lingua originaleItalian
pagine (da-a)36-36
Numero di pagine1
RivistaGIORNALE ITALIANO DI NEFROLOGIA
Volume36
Stato di pubblicazionePubblicato - 2019

Keywords

  • Adult
  • Aged
  • Cyclosporine
  • Female
  • Glomerulonephritis, Membranous
  • Glucocorticoids
  • Humans
  • Immunosuppressive Agents
  • Male
  • Middle Aged
  • Prednisone
  • Remission Induction
  • Retrospective Studies
  • cyclosporine
  • idiopathic membranous nephropathy
  • nephrotic syndrome
  • steroid therapy

Fingerprint

Entra nei temi di ricerca di '[Steroid and cyclosporine therapy in idiopathic membranous nephropathy: monocentric experience and literature review]'. Insieme formano una fingerprint unica.

Cita questo