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    
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.
R Dikow; P Quentmeier; V Schwenger; R Waldherr; K Andrassy; E Ritz; M Zeier
Related Documents :
23398599 - Improved procedural efficacy of pulmonary vein isolation using the novel second-generat...
23871569 - Dermal autografts as a substitute for acellular dermal matrices (adm) in tissue expande...
23737639 - Navicular subluxation as a radiographic finding in charcot neuroarthropathy.
24885859 - Short-stem reconstruction for megaendoprostheses in case of an ultrashort proximal femur.
24579899 - Patient activity after total hip arthroplasty: a comparison of three different bearing ...
20480529 - Egfr is a reliable preoperative renal function parameter in patients with gastric cancer.
16795979 - Operative morbidity and mortality after d2 and d4 extended dissection for advanced gast...
23777949 - Mid-term results for unicompartmental knee arthroplasty.
10192729 - The long-term results of upper dorsal sympathetic ganglionectomy and endoscopic thoraci...
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    
Department of Nephrology, University Hospital of Heidelberg, Heidelberg, Germany.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Antihypertensive Agents / therapeutic use*
Blood Pressure* / drug effects
Glomerulonephritis, Membranous / drug therapy*,  pathology,  physiopathology,  urine
Immunosuppressive Agents / adverse effects,  therapeutic use*
Kidney / pathology,  physiopathology
Middle Aged
Nephrotic Syndrome / drug therapy,  physiopathology,  urine
Renin-Angiotensin System / drug effects
Young Adult
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...