Efficacy and Safety of Low-Dose Chlorambucil in Nephrotic Patients with Idiopathic Membranous Nephropathy

Aim: This observational study aimed to evaluate the results of treatment with low-dose chlorambucil in combination with corticosteroids in patients with idiopathic membranous nephropathy (iMGN) and nephrotic syndrome. Methods: Thirty-two patients with nephrotic syndrome and biopsy-proven iMGN were i...

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Bibliographic Details
Published in:Kidney & blood pressure research Vol. 32; no. 4; pp. 263 - 267
Main Authors: Idasiak-Piechocka, Ilona, Oko, Andrzej, Łochyńska-Bielecka, Katarzyna, Skrobańska, Beata
Format: Journal Article
Language:English
Published: Basel, Switzerland S. Karger AG 01.01.2009
Subjects:
Adult
Anti-Inflammatory Agents - therapeutic use
Antineoplastic Agents, Alkylating - administration & dosage
Antineoplastic Agents, Alkylating - adverse effects
Antineoplastic Agents, Alkylating - therapeutic use
Chlorambucil - administration & dosage
Chlorambucil - adverse effects
Chlorambucil - therapeutic use
Female
Follow-Up Studies
Glomerulonephritis, Membranous - complications
Glomerulonephritis, Membranous - drug therapy
Glomerulonephritis, Membranous - pathology
Humans
Kidney Failure, Chronic - complications
Kidney Failure, Chronic - pathology
Male
Methylprednisolone - therapeutic use
Middle Aged
Nephrotic Syndrome - complications
Nephrotic Syndrome - drug therapy
Nephrotic Syndrome - pathology
Original Paper
Prednisone - therapeutic use
Proteinuria - drug therapy
Serum Albumin - metabolism
Treatment Outcome
Chlorambucil
Membranous nephropathy
Immunosuppressive treatment
ISSN:1420-4096, 1423-0143, 1423-0143
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Summary:Aim: This observational study aimed to evaluate the results of treatment with low-dose chlorambucil in combination with corticosteroids in patients with idiopathic membranous nephropathy (iMGN) and nephrotic syndrome. Methods: Thirty-two patients with nephrotic syndrome and biopsy-proven iMGN were included in the study. At presentation, 9 patients were found to be in stage 1, 13 patients in stage 2 and 10 patients in stage 3 chronic kidney disease. In all patients, i.v. methylprednisolone pulses (500 mg/day for 3 days) were administered, followed by oral prednisone at an initial dose of 1 mg/kg per day, tapered gradually after 8 weeks to the maintenance dose of 5 mg/day after 6 months, and chlorambucil 2 mg twice daily for 6 months. Results: Complete remission of nephrotic syndrome was obtained in 14 patients (47.3%) and partial remission in 16 patients (50%). Two patients relapsed after 1 year of treatment. We did not record any severe side effects in treated patients, except glucose intolerance in 4 subjects on high corticosteroid doses. Conclusion: Immunosuppressive treatment with corticosteroids and low-dose chlorambucil seems to be effective and well tolerated in nephrotic patients with iMGN.
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ISSN:1420-4096
1423-0143
1423-0143
DOI:10.1159/000239539