Document Detail


Optimal blood pressure control versus additional immunosuppressive therapy in idiopathic membranous nephropathy - a retrospective analysis.
MedLine Citation:
PMID:  19863879     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The treatment of idiopathic membranous nephropathy (MN) with nephrotic syndrome comprises immunosuppressive therapy and antihypertensive treatment with the blockade of the renin-angiotensin system (RAS). Given the relatively benign natural history of MN, an immunosuppressive-free therapeutic regimen should be considered as the primary treatment option. In a single-center, retrospective analysis we compared the outcome of 54 patients with biopsy-proven idiopathic MN 12, 24 and 60 months after initiation of therapy. All patients had RAS-blocking agents and 36 patients received additionally an immunosuppressive regimen. In both groups the patients initially had a nephrotic proteinuria (median 8.7 vs. 6.0 g/day, n.s.). Median blood pressure reduction was comparable after 12, 24 and 60 months in both groups. The median evolution of proteinuria during therapy after 12, 24 and 60 months was 3.4, 1.7 and 1.1 g/day in the group with immunosuppression compared to 3.0, 1.1 and 0.32 g/day in the non-immunosuppressive group. After 60 months no patient developed endstage renal failure. The number of severe side effects was significantly higher in patients with immunosuppression. Regarding renal function and reduction of proteinuria, patients with idiopathic MN treated without immunosuppressive therapy but with measures to ensure optimal blood pressure control and the full blockade of RAS had a similar outcome after 60 months as compared to patients who received additional immunosuppressive therapy.
Authors:
R Dikow; P Quentmeier; V Schwenger; R Waldherr; K Andrassy; E Ritz; M Zeier
Related Documents :
24977759 - Using the rothman index to predict early unplanned surgical intensive care unit readmis...
23194209 - A prospective, observational study comparing postoperative residual curarisation and ea...
2953159 - Fibromuscular dysplasia of the renal artery--management and outcome.
23522619 - Prospective comparison study of one-year outcomes for all titanium total temporomandibu...
25065089 - Comparative study on the characteristics of meckel's diverticulum removal from asymptom...
24776149 - Atrial tachycardia originating from the pulmonary vein: clinical, electrocardiographic,...
15691679 - Surgical treatment of atrial fibrillation; a systematic review.
3669169 - Ipsilateral ureteroureterostomy and pyeloureterostomy: a review of 15 years of experien...
2606619 - Sclerotherapy superior to surgery for longer survival and less rebleeding in 103 cirrho...
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Clinical nephrology     Volume:  72     ISSN:  0301-0430     ISO Abbreviation:  Clin. Nephrol.     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-10-29     Completed Date:  2010-01-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0364441     Medline TA:  Clin Nephrol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  366-72     Citation Subset:  IM    
Affiliation:
Department of Nephrology, University Hospital of Heidelberg, Heidelberg, Germany. ralfdikow@yahoo.de
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Antihypertensive Agents / therapeutic use*
Blood Pressure* / drug effects
Female
Glomerulonephritis, Membranous / drug therapy*,  pathology,  physiopathology,  urine
Humans
Immunosuppressive Agents / adverse effects,  therapeutic use*
Kidney / pathology,  physiopathology
Male
Middle Aged
Nephrotic Syndrome / drug therapy,  physiopathology,  urine
Proteinuria
Renin-Angiotensin System / drug effects
Young Adult
Chemical
Reg. No./Substance:
0/Antihypertensive Agents; 0/Immunosuppressive Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  IgG nephropathy - confusion and overlap with C1q nephropathy.
Next Document:  Prospective studies on applications of a two-cuff Swan neck catheter and a Tenckhoff catheter to Chi...