Affiliation:
1. Department of Nephrology, Affiliated Hospital of Hebei University , Lianchi District , Baoding , 071000, Hebei , China
2. The Sixth Medical Center of Pla General Hospital , Haidian District , Beijing , China
Abstract
Abstract
Objective
The aim of this study was to observe the remission of primary membranous nephropathy (PMN) and evaluate the efficacy of tacrolimus (TAC) monotherapy for PMN in comparison with TAC combined with a low-dose glucocorticoid (GC) protocol (TAC + GC).
Methods
This was tested in a prospective monocentric observational trial of 70 patients with PMN, of whom 34 received TAC (0.05–0.075 mg/kg/day) or 36 received TAC (0.05–0.075 mg/kg/day) and GC (0.3–0.5 mg/kg/day of prednisone).
Results
At 3, 6, 9, and 12 months of treatment, the effective rates in the TAC group and the TAC + GC group were similar (P > 0.05). The urinary protein quantification was reduced in patients under both therapeutic protocols, and the differences in the proteinuria quantification at 3, 6, 9, and 12 months of treatment were not statistically significant between the two groups (P > 0.05). The overall incidence of adverse reactions in the TAC group was lower than that in the TAC + GC group (23.5% < 36.1%), and the difference was statistically significant (P < 0.05).
Conclusion
TAC monotherapy for PMN could effectively reduce urinary protein quantification and increase serum albumin levels. Compared with TAC + GC, TAC monotherapy for PMN had no difference in efficacy and fewer incidences of adverse reactions.
Reference30 articles.
1. Vendemia F, Gesualdo L, Schena FP, D’Amico G, Renal Immunopathology Study Group of the Italian Society of Nephrology. Epidemiology of primary glomerulonephritis in the elderly. Report from the Italian Registry of Renal Biopsy. J Nephrol. 2001 Sep–Oct;14(5):340–52.
2. Covic A, Schiller A, Volovat C, Gluhovschi G, Gusbeth-Tatomir P, Petrica L, et al. Epidemiology of renal disease in Romania: A 10 year review of two regional renal biopsy databases. Nephrol Dial Transpl. 2006 Feb;21(2):419–24.
3. Chang JH, Kim DK, Kim HW, Park SY, Yoo TH, Kim BS, et al. Changing prevalence of glomerular diseases in Korean adults: A review of 20 years of experience. Nephrol Dial Transpl. 2009 Aug;24(8):2406–10.
4. Xu X, Wang G, Chen N, Lu T, Nie S, Xu G, et al. Long-term exposure to air pollution and increased risk of membranous nephropathy in China. J Am Soc Nephrol. 2016 Dec;27(12):3739–46.
5. Zhu P, Zhou FD, Wang SX, Zhao MH, Wang HY. Increasing frequency of idiopathic membranous nephropathy in primary glomerular disease:a 10-year renal biopsy study from a single Chinese nephrology centre. Nephrology(Carlton). 2015;20:560–6.