Efficacy and safety of low-dose chlorambucil in nephrotic patients with idiopathic membranous nephropathy.

Abstract

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.

• Authors: Ilona Idasiak-Piechocka, Andrzej Oko, Katarzyna Łochyńska-Bielecka, Beata Skrobańska
• Journal: Kidney & blood pressure research (Kidney Blood Press Res) Vol. 32 Issue 4 Pg. 263-7 ( 2009) ISSN: 1423-0143 [Electronic] Switzerland
• PMID: 19776643 (Publication Type: Clinical Trial, Journal Article)
• Copyright: (c) 2009 S. Karger AG, Basel.

Chemical References

• Anti-Inflammatory Agents
• Antineoplastic Agents, Alkylating
• Serum Albumin
• Chlorambucil
• Prednisone
• Methylprednisolone

Topics

• Adult
• Anti-Inflammatory Agents (therapeutic use)
• Antineoplastic Agents, Alkylating (administration & dosage, adverse effects, therapeutic use)
• Chlorambucil (administration & dosage, adverse effects, therapeutic use)
• Female
• Follow-Up Studies
• Glomerulonephritis, Membranous (complications, drug therapy, pathology)
• Humans
• Kidney Failure, Chronic (complications, pathology)
• Male
• Methylprednisolone (therapeutic use)
• Middle Aged
• Nephrotic Syndrome (complications, drug therapy, pathology)
• Prednisone (therapeutic use)
• Proteinuria (drug therapy)
• Serum Albumin (metabolism)
• Treatment Outcome