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Low-dose cyclosporine in treatment of membranous nephropathy with nephrotic syndrome: effectiveness and renal safety
| Content Provider | Scilit |
|---|---|
| Author | Yu, Xiaojuan Ruan, Lin Qu, Zhen Cui, Zhao Zhang, Yimiao Wang, Xin Meng, Liqiang Liu, Xiaojing Wang, Fang Zhang, Ying Liu, Gang Yang, Li |
| Copyright Year | 2017 |
| Description | To observe effectiveness and renal safety of long-term low-dose cyclosporine in idiopathic membranous nephropathy (IMN). Sixty-eight patients were enrolled in this prospective cohort study. Renal endpoint was defined as a decrease in eGFR ≥50% from baseline and a development of eGFR ≤60 ml/min/1.73m2. A cyclosporine dose of 2.0 ± 0.5 mg/kg/d and a prednisone of 0.3 ± 0.2 mg/kg/d were prescribed. The duration of cyclosporine treatment was 27 (3-80) months. The overall remission rate was 91% with a relapse rate of 42%. Fourteen patients had cyclosporine-related acute renal injury (CsA-ARI) within the first three months, and 16 patients had cyclosporine related chronic renal injury (CsA-CRI) within the first year. At the end of follow-up (50 ± 18 months), 16 patients (24%) reached renal endpoint. Presence of intimal fibrosis of small artery and higher time-averaged proteinuria were identified as independent risk factors for renal endpoint. RAS inhibition treatment decreased the risk of poor renal outcome. Patients in CsA-ARI group had the highest proteinuria at the third month, the highest time-average proteinuria and the highest proportion of cases reaching renal endpoint. Patients with CsA-CRI were of the oldest age and with the lowest baseline eGFR. Low-dose cyclosporine is effective in treating IMN. CsA-ARI and no response in proteinuria during the first three months of cyclosporine treatment had the lowest benefit/risk ratio, and these patients should be switched to non-calcineurin-inhibitor based regimen. Patients of older age, with lower baseline eGFR, or having intimal sclerosis of small artery, are more likely to develop progressive renal dysfunction. |
| Related Links | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6446165/pdf |
| Ending Page | 697 |
| Page Count | 10 |
| Starting Page | 688 |
| ISSN | 0886022X |
| e-ISSN | 15256049 |
| DOI | 10.1080/0886022x.2017.1373130 |
| Journal | Renal Failure |
| Issue Number | 1 |
| Volume Number | 39 |
| Language | English |
| Publisher | Informa UK Limited |
| Publisher Date | 2017-01-01 |
| Access Restriction | Open |
| Subject Keyword | Journal: Renal Failure Urology and Nephrology Cyclosporine Membranous Nephropathy Nephrotic Syndrome Nephrotoxicity Renal Injury |
| Content Type | Text |
| Resource Type | Article |
| Subject | Critical Care and Intensive Care Medicine Nephrology |
