Article

Cyclosporine in the treatment of membranoproliferative glomerulonephritis.

Department of Nephrology, Taleghani Hospital, Shaheed Beheshti University of Medical Sciences, Tehran, Iran.
Archives of Iranian medicine (impact factor: 0.97). 02/2008; 11(1):26-9. DOI:08111/AIM.008 pp.26-9
Source: PubMed

ABSTRACT Therapeutic approach to patients with idiopathic membranoproliferative glomerulonephritis is still controversial. Because it is more common in developing countries, the studies about it are limited.
We used cyclosporine to treat 18 patients with membranoproliferative glomerulonephritis who were resistant to other treatment protocols such as using aspirin, dipyridamole, or steroids. All patients were treated with cyclosporine plus low-dose prednisone and were followed for an average 108 weeks.
Partial or complete remission of proteinuria occurred in 94% of the patients (P<0.01). Relapse occurred in one (14.2%) of remitters after discontinuation of the drug. But the remainder stayed in remission to the end of the observation period. There was a 507% decrease in the baseline creatinine clearance in one patient (5.5%).
These results suggest that cyclosporine may be an effective therapeutic agent in the treatment of resistant idiopathic membranoproliferative glomerulonephritis. Although the response is appeared later than other types of glomerulonephritis, but a long-term decrease in proteinuria and preservation of filtration function were observed in a significant proportion of the treated patients.

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    Article: Membranoproliferative glomerulonephritis.
    Bassam Alchi, David Jayne
    [show abstract] [hide abstract]
    ABSTRACT: Membranoproliferative glomerulonephritis is an uncommon kidney disorder characterized by mesangial cell proliferation and structural changes in glomerular capillary walls. It can be subdivided into idiopathic and secondary forms, which are differentially diagnosed by a review of clinical features, laboratory data, and renal histopathology. Three types-I, II, and III-have been defined by pathologic features. All three types are associated with hypocomplementemia, but they manifest somewhat different mechanisms of complement activation. Type II, also known as "dense deposit disease", is associated with the presence of C3-nephritic factor. Membranoproliferative glomerulonephritis primarily affects children and young adults, with patients presenting with nephrotic or nephritic syndrome or with asymptomatic renal disease. This type of glomerulonephritis often progresses slowly to end-stage renal disease, and it tends to recur after renal transplantation, especially type II. The efficacy of various forms of treatment remains controversial; however, long-term steroid treatment seems to be effective in children with nephrotic-range proteinuria. Improvement in renal outcomes largely relies on the evaluation of more selective agents in carefully controlled studies.
    Pediatric Nephrology 11/2009; 25(8):1409-18. · 2.52 Impact Factor
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.

Keywords

18 patients
 
average 108 weeks
 
baseline creatinine clearance
 
complete remission
 
countries
 
cyclosporine
 
dipyridamole
 
discontinuation
 
effective therapeutic agent
 
glomerulonephritis
 
idiopathic membranoproliferative glomerulonephritis
 
long-term decrease
 
low-dose prednisone
 
membranoproliferative glomerulonephritis
 
observation period
 
patients
 
resistant idiopathic membranoproliferative glomerulonephritis
 
Therapeutic approach
 
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treatment protocols