Rostoker G
Service de Néphrologie, INSERM U 139, Hôpital Henri Mondor, Créteil, France.
Nephrologie. 1992;13(5):207-13.
The survey of open trials of Cyclosporin (CyA) in membranous nephropathy demonstrates that low dose CyA (4-5 mg/kg/day) given for a long term therapy (more than a year) can induce remission in 60-70% of the patients. Shorter therapy must be avoided because of the high rate of relapse after CyA withdrawal. Antiproteinuric effect of CyA does not seem to be related to an haemodynamic mechanism. Relapse of the nephrotic syndrome after CyA withdrawal after long term therapy can be observed but is far less frequent than in corticodependent nephrosis or in short term therapy with CyA. Further studies are needed to evaluate the risk of long-term nephrotoxicity and to determine what kind of patients should be treated. Controlled trials of CyA in membranous nephropathy against reference treatments are also warranted.
环孢素（CyA）治疗膜性肾病的开放试验研究表明，长期治疗（超过一年）给予低剂量CyA（4-5毫克/千克/天）可使60%-70%的患者病情缓解。由于停用CyA后复发率高，必须避免较短疗程的治疗。CyA的抗蛋白尿作用似乎与血流动力学机制无关。长期治疗后停用CyA可观察到肾病综合征复发，但远不如激素依赖型肾病或CyA短期治疗时频繁。需要进一步研究以评估长期肾毒性风险，并确定哪些患者应接受治疗。也有必要开展CyA治疗膜性肾病与对照治疗的对照试验。
