Effectiveness and safety of cyclophosphamide or tacrolimus therapy for idiopathic membranous nephropathy

Renal Failure

Fang Jiang¹  Honghong Zou²  Gaosi Xu² 

[1] People's Hospital of Xinyu City;the Second Affiliated Hospital of Nanchang University;

关键词: idiopathic membranous nephropathy;    tacrolimus;    cyclophosphamide;    retrospective study;    effectiveness;   

DOI  :  10.1080/0886022X.2019.1637758

来源: DOAJ

【 摘 要 】

Background: Guidelines recommend combined therapy of glucocorticoid and cyclophosphamide (CYC) for patients with idiopathic membranous nephropathy (IMN), while it is associated with severe adverse effects. We conducted a retrospective study to evaluate the effectiveness and safety of glucocorticoid plus tacrolimus (TAC) for IMN. Methods: Two hundred and three kidney-biopsy-proven IMN patients were enrolled in this study. One group (n = 142) received glucocorticoid combined with intravenous CYC (750 mg/m2 body surface) and the other group (n = 61) received glucocorticoid combined with oral TAC (target blood concentration of 4–8 ng/mL). The primary outcomes were achievement of remission and incidence of adverse events. The secondary end points included relapse rates, 24 h urinary protein (UP), serum albumin, serum creatinine and estimated glomerular filtration rate. Results: Over the 18-month observation period, the study suggested that the remission rates at the first 3 months were significantly higher in TAC group than in CYC group (72.1% versus 54.9%, p < .05). Although the cumulative incidence of serious and non-serious adverse events was not different significantly between the two groups, the incidence after first 3 months was lower in TAC group. 24hUP and serum albumin improved in TAC group more than the CYC group (p < .05) over the observed period. Conclusion: Because of its short-term effectiveness and long-term safety profile, glucocorticoid plus TAC might be a better option for IMN.

【 授权许可】

Unknown