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学科主题临床医学
Tacrolimus Combined With Corticosteroids in Treatment of Nephrotic Idiopathic Membranous Nephropathy: A Multicenter Randomized Controlled Trial
Chen, Min1; Li, Hang2; Li, Xia-Yu3; Lu, Fu-Ming4; Ni, Zhao-Hui5; Xu, Fei-Fei6; Li, Xue-Wang2; Chen, Jiang-Hua3; Wang, Hai-Yan1; Chinese Nephropathy Membranous Stu1
关键词Tacrolimus Idiopathic Membranous Nephropathy Nephrotic Syndrome
刊名AMERICAN JOURNAL OF THE MEDICAL SCIENCES
2010-03-01
DOI10.1097/MAJ.0b013e3181ca3a7d
339期:3页:233-238
收录类别SCI
文章类型Article
WOS标题词Science & Technology
类目[WOS]Medicine, General & Internal
研究领域[WOS]General & Internal Medicine
关键词[WOS]METHYLPREDNISOLONE PLUS CHLORAMBUCIL ; CYCLOSPORINE-A ; CYCLOPHOSPHAMIDE ; DISEASE ; NEPHRITIS ; REMISSION ; STEROIDS ; THERAPY ; RISK
英文摘要

Background: Idiopathic membranous nephropathy (IMN), a common cause of nephrotic syndrome in adults, is usually treated with corticosteroids in combination with cyclophosphamide or cyclosporine. A recent placebo-controlled study suggested that tacrolimus monotherapy was effective in IMN. However, the effectiveness of tacrolimus versus classic regimen and its potential nephrotoxicity remain inconclusive. This study evaluated the efficacy and safety of tacrolimus plus prednisone in patients with nephrotic IMN. Methods: Seventy-three patients with nephrotic IMN were recruited in this multicenter randomized controlled trial, 39 receiving tacrolimus and prednisone, while 34 receiving cyclophosphamide and prednisone. Tacrolimus was given at 0.1 mg/kg/d initially and adjusted to a blood trough level at 5 to 10 ng/mL for 6 months and then reduced to 2 to 5 ng/mL in the subsequent 3 months. Results: Intention-to-treat analysis suggested that the remission rate at the end of the sixth month was significantly higher in tacrolimus group than that in cyclophosphamide group (85% versus 65%, P < 0.05). The decrease of proteinuria was significantly greater in tacrolimus group. At the end of the 12th month, the remission rates were comparable between these 2 groups. Patients treated with tacrolimus were more likely to develop glucose intolerance (or diabetes mellitus), infection, and hypertension. No obvious nephrotoxicity of calcineurin inhibitor was found in repeat renal biopsy. Conclusions: Tacrolimus plus corticosteroids is an alternative therapeutic regimen for nephrotic IMN. The short-term efficacy might be better than cyclophosphamide plus prednisone.

语种英语
WOS记录号WOS:000275419000008
引用统计
被引频次:45[WOS]   [WOS记录]     [WOS相关记录]
文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/50938
专题北京大学第一临床医学院_肾脏内科
作者单位1.Peking Univ, Hosp 1, Dept Nephrol, Beijing 100034, Peoples R China
2.Beijing Union Med Coll Hosp, Dept Nephrol, Beijing, Peoples R China
3.Zhejiang Univ, Coll Med, Affiliated Hosp 1, Kidney Dis Ctr, Hangzhou 310003, Zhejiang, Peoples R China
4.Fudan Univ, Huashan Hosp, Dept Nephrol, Shanghai 200433, Peoples R China
5.Shanghai Jiao Tong Univ, Sch Med, Renji Hosp, Div Renal, Shanghai 200030, Peoples R China
6.Wenzhou Med Coll, Hosp 1, Dept Nephrol, Wenzhou, Zhejiang, Peoples R China
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GB/T 7714
Chen, Min,Li, Hang,Li, Xia-Yu,et al. Tacrolimus Combined With Corticosteroids in Treatment of Nephrotic Idiopathic Membranous Nephropathy: A Multicenter Randomized Controlled Trial[J]. AMERICAN JOURNAL OF THE MEDICAL SCIENCES,2010,339(3):233-238.
APA Chen, Min.,Li, Hang.,Li, Xia-Yu.,Lu, Fu-Ming.,Ni, Zhao-Hui.,...&Chinese Nephropathy Membranous Stu.(2010).Tacrolimus Combined With Corticosteroids in Treatment of Nephrotic Idiopathic Membranous Nephropathy: A Multicenter Randomized Controlled Trial.AMERICAN JOURNAL OF THE MEDICAL SCIENCES,339(3),233-238.
MLA Chen, Min,et al."Tacrolimus Combined With Corticosteroids in Treatment of Nephrotic Idiopathic Membranous Nephropathy: A Multicenter Randomized Controlled Trial".AMERICAN JOURNAL OF THE MEDICAL SCIENCES 339.3(2010):233-238.
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