Document Detail


Treatment aspects of primary nephrotic syndrome in adults.
MedLine Citation:
PMID:  16879107     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Strict therapy protocol, which would be used universally for certain morphological forms of primary nephrotic syndrome, does not exist. The aim of the study was to show the effects of used therapy protocol in treatment of primary nephrotic syndrome at the Institute of Nephrology, Clinical Center University of Sarajevo in period of 2000-2005. The retrospective analysis covered 48 patients (17 women and 31 men) with idiopathic nephrotic syndrome, where pathomorphological changes were proved by kidney biopsy. Minimal change disease was confirmed with 6 (12.5%) patients. All patients were initially treated with corticosteroids with dose of 1 mg/kg of body weight. Five patients were in the group of primary responders (83.3%) with long term total remission, and 1 patient (16.6%) was a primary responder with 3 relapses in 8 months with a therapy of corticosteroids and bolus of cyclophosphamide. Diffuse mesangial proliferative glomerulonephritis was shown in 13 patients (27.1%). Seven patients from this group were treated with corticosteroid therapy (1 mg/kg of body weight for 4 weeks, followed by 0.5 mg/ kg of body weight until therapeutical response was achieved, and finally gradual exclusion of therapy after eight weeks in responsive patients). Six patients were treated with corticosteroids and one-month of bolus cyclophosphamide during half of year (10-5 mg/kg of body weight). Total remission was achieved in 37,9% of the patients. The IgA nephropathy presented with the nephrotic syndrome was shown in 10.4% (5) of the patients. Three patients from this group were treated with corticosteroid therapy (1 mg/kg of body weight for 4 weeks, followed by 0,5 mg/ kg of body weight until therapeutical response was achieved, and finally gradual exclusion of therapy after eight weeks in responsive patients) and.2 patients with corticosteroids and cyclophosphamide (1.5 mg/kg of body weight) during 6 months. Complete remission of nephrotic syndrome from this pathomorphological category was achieved in 2 patients. Membranoproliferative glomerulonephritis was shown in 6 patients (12.5%). All were treated with corticosteroids plus bolus of cyclophosphamide. Partial remission was achieved in one patient. Membranous glomerulonephritis was confirmed in 18 patients (37.5 %). Combined therapy of corticosteroids and bolus of cyclophosphamide was used in 7/18 patients, in 2/18 patients therapy of corticosteroids and per os cyclophosphamide (2 mg/kg of body weight) and in 9/18 patients cyclosporine therapy (3 mg/kg of body weight). Complete remission was achieved in 38.8% of the patients. A high percentage of achieved remissions of primary nephrotic syndrome in adults shows the efficiency of immunomodulating therapy used. Membranoproliferative glomerulonephritis still remains a therapy problem.
Authors:
Senija Rasić; Snjezana Uncanin; Jasminka Dzemidzić; Kenana Aganović; Amira Srna; Ismar Rasić
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Bosnian journal of basic medical sciences / Udruženje basičnih mediciniskih znanosti = Association of Basic Medical Sciences     Volume:  6     ISSN:  1512-8601     ISO Abbreviation:  Bosn J Basic Med Sci     Publication Date:  2006 May 
Date Detail:
Created Date:  2006-08-01     Completed Date:  2006-08-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101200947     Medline TA:  Bosn J Basic Med Sci     Country:  Bosnia and Hercegovina    
Other Details:
Languages:  eng     Pagination:  16-20     Citation Subset:  IM    
Affiliation:
Institute for Nephrology, Clinical Centre University Sarajevo, Bolnicka 25, 71000 Sarajevo, Bosnia and Herzegovina.
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MeSH Terms
Descriptor/Qualifier:
Adrenal Cortex Hormones / therapeutic use*
Adult
Blood Proteins / analysis
Creatinine / analysis
Cyclophosphamide / therapeutic use*
Drug Therapy, Combination
Female
Glomerulonephritis / complications
Humans
Immunosuppressive Agents / therapeutic use*
Male
Middle Aged
Nephrosis, Lipoid / complications
Nephrotic Syndrome / blood,  etiology,  therapy*
Proteinuria / blood
Retrospective Studies
Chemical
Reg. No./Substance:
0/Adrenal Cortex Hormones; 0/Blood Proteins; 0/Immunosuppressive Agents; 50-18-0/Cyclophosphamide; 60-27-5/Creatinine

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