Nephrotic Syndrome Caused by Membranous Nephropathy : Response to a Short Course of Cyclophosphamide Alternating with Prednisolone

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概要

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•   Objective  The optimal duration of immunosuppressive therapy and the timing of treatment for treating membranous nephropathy (MN) have yet to be established. We examined outcomes of a short course of cyclophosphamide alternating with prednisolone for MN patients with nephrotic syndrome.  Methods and Patients  Cyclophosphamide (2 mg/kg/day for 8 weeks) combined with prednisolone (1 mg/kg every 48 hours for 8 weeks, then tapering off for 1 year) was prescribed for 28 MN patients (12 men and 16 women; mean age 52.4±2.25 years SEM). We first evaluated the response rates to this combined therapy, then compared the clinical characteristics of those who achieved remission (group A) with those who did not (group B) within 6 months of the start of treatment.  Results  The incidences of complete and partial remission increased with the follow-up period; 32 and 21% by 6 months, 54 and 29% by 12 months, and 79 and 11% by 24 months, respectively. Serum IgG (906±100.8 versus 562±66.1 mg/day; p<0.01) was significantly higher in group A, and the selectivity index (CIgG/Calbumin 0.16±0.015 versus 0.30±0.040; p<0.01), significantly lower. Nephrotic syndrome persisted in 3 group B patients (23%), who finally had impaired renal function.  Conclusion  MN patients with nephrotic syndrome responded favorably to a short course of cyclophosphamide combined with prednisolone. The serum IgG level and selectivity index may serve as markers of early response to this treatment.

• 社団法人　日本内科学会の論文
• 2004-01-01

著者

• Eto Tanenao

  Etoh Clinic

• Eto T

  Circulatory And Body Fluid Regulation Faculty Of Medicine University Of Miyazaki

• Fujimoto Shinichi

  奈良県立医科大学 総合医療学

• Eto Tanenao

  First Department Of Internal Medicine Faculty Of Medicine University Of Miyazaki

• Eto T

  First Department Of Internal Medicine Miyazaki Medical College University Of Miyazaki

• Eto Tanenao

  宮崎大学 循環体液制御学

• FUJIMOTO Shouichi

  First Department of Internal Medicine, Miyazaki Medical College, University of Miyazaki

• SATO Yuji

  First Department of Internal Medicine, Miyazaki Medical College, University of Miyazaki

• YAMADA Kazuhiro

  First Department of Internal Medicine, Miyazaki Medical College, University of Miyazaki

• HARA Seiichirou

  First Department of Internal Medicine, Miyazaki Medical College, University of Miyazaki

• HISANAGA Shuichi

  First Department of Internal Medicine, Miyazaki Medical College, University of Miyazaki

• Yamada Kazuhiro

  First Department Of Internal Medicine Miyazaki Medical College University Of Miyazaki

• Hara Seiichiro

  First Department Of Internal Medicine Miyazaki Medical College University Of Miyazaki

• Eto Tanenao

  First Department Of Internal Medicine Department Of Pathology Miyazaki Medical College

• Hisanaga Shuichi

  宮崎医科大学 1内

• Sato Yuji

  First Department Of Internal Medicine Miyazaki Medical College University Of Miyazaki

• Hisanaga Shuichi

  The First Department Of Internal Medicine Miyazaki Medical College

• Hisanaga Shuichi

  First Department Of Internal Medicine Miyazaki Medical College University Of Miyazaki

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