Corticosteroids, cyclophosphamide, and chlorambucil therapy of membranous nephropathy.
Semin Nephrol
; 23(4): 355-61, 2003 Jul.
Article
em En
| MEDLINE
| ID: mdl-12923723
ABSTRACT
Corticosteroids and cytotoxic agents have been studied widely in membranous nephropathy (MN). However, controlled studies with corticosteroids have not shown a clear benefit of these agents on the outcome of the disease. Some controlled trials reported that cytotoxic agents can reduce proteinuria significantly, but it was difficult to assess the efficacy of these drugs in protecting renal function because of the short follow-up period of the studies. Three randomized controlled trials showed that a 6-month treatment regimen based on corticosteroids and a cytotoxic agent, giving each for 1 month at a time in an alternating schedule, could favor remission of the nephrotic syndrome and protect renal function. Taken together, the results of these trials at the end of the follow-up period, 74% of the 174 treated patients were without nephrotic syndrome, 4 patients were on chronic dialysis, and 2 patients died. Good results with cytotoxic drugs, often associated with corticosteroids, also have been reported in progressive membranous nephropathy. However, in patients with renal insufficiency side effects were frequent and severe. Moreover, in most cases renal function improved but did not return to normal.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Glomerulonefrite Membranosa
/
Clorambucila
/
Antineoplásicos Alquilantes
/
Ciclofosfamida
/
Glucocorticoides
/
Imunossupressores
Tipo de estudo:
Clinical_trials
Limite:
Humans
Idioma:
En
Revista:
Semin Nephrol
Ano de publicação:
2003
Tipo de documento:
Article
País de afiliação:
Itália