Díaz-Soler Felipe, Bernal María José, Gonzalez Franco, Pereira Ismael, Abusleme Francisco, Siel Daniela
Escuela de Medicina Veterinaria, Facultad de Medicina y Ciencias de la Salud, Universidad Mayor, Santiago 8580745, Chile.
Escuela de Medicina Veterinaria, Facultad de ciencias de la Vida, Universidad Andrés Bello, Santiago 8370251, Chile.
Vet Sci. 2025 Jul 31;12(8):721. doi: 10.3390/vetsci12080721.
Protein-losing nephropathy (PLN) involves a heterogeneous group of pathologies leading to selective glomerular damage and development of renal disease. ICGN, the main cause of PLN, requires immunosuppressive treatment. However, the scientific evidence in veterinary medicine on immunosuppressive therapeutic schemes in this condition is limited. The aim of this study is to describe the clinical and paraclinical evolution of five dogs with PLN, presumably associated with ICGN, treated with chlorambucil as immunosuppressive monotherapy. Suspected IGCN was established by the presence of a urine protein-creatinine ratio (UPC) ≥ 3 without response to standard therapy, hypoalbuminemia < 2, or progressive azotemia. Patients were treated with a dosage range of chlorambucil from 0.16 to 0.4 mg/kg (mean 0.25 mg/kg) every 24 h as the sole immunosuppressant. In the end, 4/5 patients showed significant clinical improvement, 3/3 had resolution of the nephrotic syndrome, 5/5 had a sustained decrease in UPC values during follow-up and no relevant adverse effects were observed. In this report, chlorambucil proved to be a well-tolerated and potentially effective monotherapy for immune-mediated PLN in dogs.
蛋白丢失性肾病（PLN）涉及一组异质性病理状况，可导致选择性肾小球损伤和肾脏疾病的发展。ICGN是PLN的主要病因，需要进行免疫抑制治疗。然而，兽医学中关于这种情况下免疫抑制治疗方案的科学证据有限。本研究的目的是描述五只可能与ICGN相关的PLN犬，接受苯丁酸氮芥作为单一免疫抑制治疗的临床和副临床演变情况。通过尿蛋白肌酐比值（UPC）≥3且对标准治疗无反应、低白蛋白血症<2或进行性氮质血症来确定疑似IGCN。患者每24小时接受0.16至0.4毫克/千克（平均0.25毫克/千克）剂量范围的苯丁酸氮芥作为唯一的免疫抑制剂进行治疗。最终，4/5的患者显示出显著的临床改善，3/3的患者肾病综合征得到缓解，5/5的患者在随访期间UPC值持续下降，且未观察到相关不良反应。在本报告中，苯丁酸氮芥被证明是一种耐受性良好且可能有效的犬免疫介导性PLN单一疗法。
