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İmmünsupresif Tedavilere Dirençli Birincil Fokal Segmental Glomerulosklerozlu Hastalarda Takrolimusun Etkinliği

Efficacy of Tacrolimus in Patients with Primary Focal Segmental Glomerulosclerosis Resistant to Immunosuppressive Treatments

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 2011
DOI: 
DOI 10.5262/tndt.2011.1001.09

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
OBJECTIV E: We investigated the efficacy and safety of tacrolimus in patients with primary focal segmental glomerulosclerosis (FSGS) resistant to treatment in this study. MA TERIAL and M ETHODS: This prospective study included 9 patients (5 female/4 male) with FSGS resistant to steroids. Their immunosuppressive treatments except corticosteroids were stopped at least six months previously. Tacrolimus (4 mg/day) treatment was administered. The daily urinary protein excretion, serum creatinine, albumin and total cholesterol values were measured before and after treatment. RESUL TS: The mean level of daily urinary protein excretion, serum creatinine and serum albumin at the baseline was 4.7 ± 3.3 g/day, 1.2 ± 0.6 mg/dL, and 3.5 ± 0.7 g/dL, respectively. The daily urinary protein excretion significantly reduced from the 1st month of the treatment. At the 6th month, complete remission was achieved in 3 patients (33%) and partial remission in 2 patients (22%). 3 patients were resistant to the treatment. There was no difference in serum albumin, creatinine and cholesterol levels after the treatment when compared to the baseline levels. CONCLU SION: Tacrolimus is a safe and effective treatment in patients with FSGS resistant to treatment. However, the tendency to relapse in all patients who have complete or partial remission when the treatment was withdrawn demonstrates dependence on treatment.
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Abstract (Original Language): 
AMA Ç: Bu çalışmada, tedaviye dirençli birincil fokal segmental glomerulosklerozlu (FSGS) hastalarda takrolimusun etkinliğini ve güvenirliğini araştırdık. GEREÇ ve YÖN TEML ER: Bu prospektif çalışma steroidlere dirençli 9 birincil FSGS’li hastayı kapsadı (5 kadın/4 erkek). Hastaların en az altı ay öncesinden kortikosteroidler dışındaki immünsupresif tedavileri kesildi. Takrolimus tedavisi (4 mg/gün) başlandı. Tedavi öncesi ve sonrası günlük idrar protein atılımı, serum kreatinin, albumin ve kolesterol düzeyleri ölçüldü. BUL GULA R: Başlangıçta ortalama günlük idrar protein atılım, serum kreatinin ve albumin düzeyleri sırasıyla 4,7 ± 3,3 g/gün, 1,2 ± 0,6 mg/dL ve 3,5 ± 0,7 g/dL idi. Tedavinin 1. Ayından itibaren günlük idrar protein atılımı anlamlı azaldı. 6. ayda 3 hastada tam düzelme (%33), 2 hastada kısmi düzelme (%22) başarıldı. 3 hasta tedaviye dirençli idi. Tedavi sonrası serum albumin, kreatinin ve kolesterol düzeylerinde bazal düzeyler ile karşılaştırıldığında anlamlı bir fark yoktu. SONU Ç: Tedaviye dirençli birincil FSGS’li hastalarda takrolimus güvenilir ve etkili bir tedavi seçeneğidir. Ancak tam ve kısmi düzelmeye giren tüm hastalarda tedavi çekildiğinde depreşme eğilimi olması, tedavi bağımlılığını göstermektedir
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