Document Detail


Spontaneous remission of nephrotic syndrome in idiopathic membranous nephropathy.
MedLine Citation:
PMID:  20110379     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Spontaneous remission is a well known characteristic of idiopathic membranous nephropathy, but contemporary studies describing predictors of remission and long-term outcomes are lacking. We conducted a retrospective, multicenter cohort study of 328 patients with nephrotic syndrome resulting from idiopathic membranous nephropathy that initially received conservative therapy. Spontaneous remission occurred in 104 (32%) patients: proteinuria progressively declined after diagnosis until remission of disease at 14.7 +/- 11.4 months. Although spontaneous remission was more frequent with lower levels of baseline proteinuria, it also frequently occurred in patients with massive proteinuria: 26% among those with baseline proteinuria 8 to 12 g/24 h and 22% among those with proteinuria >12 g/24 h. Baseline serum creatinine and proteinuria, treatment with angiotensin-converting enzyme inhibitors or angiotensin receptor antagonists, and a >50% decline of proteinuria from baseline during the first year of follow-up were significant independent predictors for spontaneous remission. Only six patients (5.7%) experienced a relapse of nephrotic syndrome. The incidence of death and ESRD were significantly lower among patients with spontaneous remission. In conclusion, spontaneous remission is common among patients with nephrotic syndrome resulting from membranous nephropathy and carries a favorable long-term outcome with a low incidence of relapse. A decrease in proteinuria >50% from baseline during the first year predicts spontaneous remission.
Authors:
Natalia Polanco; Elena Gutiérrez; Adelardo Covarsí; Francisco Ariza; Agustín Carreño; Ana Vigil; José Baltar; Gema Fernández-Fresnedo; Carmen Martín; Salvador Pons; Dolores Lorenzo; Carmen Bernis; Pilar Arrizabalaga; Gema Fernández-Juárez; Vicente Barrio; Milagros Sierra; Ines Castellanos; Mario Espinosa; Francisco Rivera; Aniana Oliet; Francisco Fernández-Vega; Manuel Praga;
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2010-01-28
Journal Detail:
Title:  Journal of the American Society of Nephrology : JASN     Volume:  21     ISSN:  1533-3450     ISO Abbreviation:  J. Am. Soc. Nephrol.     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-04-01     Completed Date:  2010-04-22     Revised Date:  2011-07-27    
Medline Journal Info:
Nlm Unique ID:  9013836     Medline TA:  J Am Soc Nephrol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  697-704     Citation Subset:  IM    
Affiliation:
Hospital 12 de Octubre, Madrid, Spain.
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MeSH Terms
Descriptor/Qualifier:
Cohort Studies
Female
Glomerulonephritis, Membranous / complications*
Humans
Male
Middle Aged
Nephrotic Syndrome / etiology*,  therapy
Proteinuria / etiology
Remission, Spontaneous
Retrospective Studies
Comments/Corrections
Comment In:
J Am Soc Nephrol. 2010 Apr;21(4):551-2   [PMID:  20299357 ]

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