Bagheri Nazila, Nemati Eghlim, Rahbar Khosro, Nobakht Ali, Einollahi Behzad, Taheri Saeed
Department of Nephrology, Taleghani Hospital, Shaheed Beheshti University of Medical Sciences, Tehran, Iran.
Arch Iran Med. 2008 Jan;11(1):26-9.
Therapeutic approach to patients with idiopathic membranoproliferative glomerulonephritis is still controversial. Because it is more common in developing countries, the studies about it are limited.
We used cyclosporine to treat 18 patients with membranoproliferative glomerulonephritis who were resistant to other treatment protocols such as using aspirin, dipyridamole, or steroids. All patients were treated with cyclosporine plus low-dose prednisone and were followed for an average 108 weeks.
Partial or complete remission of proteinuria occurred in 94% of the patients (P<0.01). Relapse occurred in one (14.2%) of remitters after discontinuation of the drug. But the remainder stayed in remission to the end of the observation period. There was a 507% decrease in the baseline creatinine clearance in one patient (5.5%).
These results suggest that cyclosporine may be an effective therapeutic agent in the treatment of resistant idiopathic membranoproliferative glomerulonephritis. Although the response is appeared later than other types of glomerulonephritis, but a long-term decrease in proteinuria and preservation of filtration function were observed in a significant proportion of the treated patients.
特发性膜增生性肾小球肾炎患者的治疗方法仍存在争议。由于该病在发展中国家更为常见，相关研究有限。
我们使用环孢素治疗18例对阿司匹林、双嘧达莫或类固醇等其他治疗方案耐药的膜增生性肾小球肾炎患者。所有患者均接受环孢素加小剂量泼尼松治疗，平均随访108周。
94%的患者蛋白尿部分或完全缓解（P<0.01）。停药后，1例缓解患者（14.2%）复发。但其余患者在观察期结束时仍处于缓解状态。1例患者的基线肌酐清除率下降了507%（5.5%）。
这些结果表明，环孢素可能是治疗耐药性特发性膜增生性肾小球肾炎的有效治疗药物。虽然反应出现的时间比其他类型的肾小球肾炎晚，但在相当比例的治疗患者中观察到蛋白尿长期减少和滤过功能得以保留。
