他克莫司治疗难治性原发性膜性肾病——附3例报告
Tacrolimus in resistant primary membranous nephropathy--a report of 3 cases.
作者信息
Szeto C C, Leung C B, Lai F M M, Li P K T
机构信息
Department of Medicine and Therapeutics, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, Hong Kong.
出版信息
Clin Nephrol. 2003 Apr;59(4):293-6. doi: 10.5414/cnp59293.
AIM
To study the efficacy and safety of tacrolimus in primary membranous nephropathy.
METHOD
We describe 3 patients with primary membranous nephropathy who were either resistant to or could not tolerate steroid with or without cytotoxic agents. They were treated with tacrolimus 0.2 mg/kg/day for 6 months. The dosage of tacrolimus was adjusted to keep a whole blood tacrolimus level of 5-10 ng/ml.
RESULTS
One patient had almost complete disappearance of proteinuria while the other 2 had at least 50% reduction in proteinuria. Proteinuria increased again in 2 of the patients after tacrolimus was stopped, but in neither of them proteinuria returned to the pretreatment level 6 months after tacrolimus was stopped.
CONCLUSION
We conclude that tacrolimus may have a modest efficacy in the treatment of resistant membranous nephropathy.
目的
研究他克莫司治疗原发性膜性肾病的疗效及安全性。
方法
我们描述了3例原发性膜性肾病患者，这些患者对糖皮质激素（无论是否联用细胞毒药物）耐药或不耐受。他们接受他克莫司0.2 mg/（kg·天）治疗6个月。调整他克莫司剂量以使全血他克莫司水平维持在5 - 10 ng/ml。
结果
1例患者蛋白尿几乎完全消失，另外2例患者蛋白尿至少减少50%。2例患者在停用他克莫司后蛋白尿再次增加，但在他克莫司停用6个月后，他们的蛋白尿均未恢复到治疗前水平。
结论
我们得出结论，他克莫司在治疗耐药性膜性肾病方面可能有一定疗效。
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