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

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  • Additional Information
    • Source:
      Publisher: Società Italiana di Nefrologia Country of Publication: Italy NLM ID: 9426434 Publication Model: Electronic Cited Medium: Internet ISSN: 1724-5990 (Electronic) Linking ISSN: 03935590 NLM ISO Abbreviation: G Ital Nefrol Subsets: MEDLINE
    • Publication Information:
      Publication: <2013- >: Rome : Società Italiana di Nefrologia.
      Original Publication: Milano : Wichtig editore
    • Subject Terms:
      Cyclosporine/*therapeutic use ; Glomerulonephritis, Membranous/*drug therapy ; Glucocorticoids/*therapeutic use ; Immunosuppressive Agents/*therapeutic use ; Prednisone/*therapeutic use; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Remission Induction ; Retrospective Studies
    • 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.
      (Copyright by Società Italiana di Nefrologia SIN, Rome, Italy.)
    • Contributed Indexing:
      Keywords: cyclosporine; idiopathic membranous nephropathy; nephrotic syndrome; steroid therapy
    • Accession Number:
      0 (Glucocorticoids)
      0 (Immunosuppressive Agents)
      83HN0GTJ6D (Cyclosporine)
      VB0R961HZT (Prednisone)
    • Publication Date:
      Date Created: 20190629 Date Completed: 20200130 Latest Revision: 20200130
    • Publication Date:
      20240829
    • Accession Number:
      31251003