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Membranoproliferatif Glomerülonefritlerin Tedavisinde İmmünsupresif Ajanlar

Immunosuppressive Agents in the Treatment of Membranoproliferative Glomerulonephritis

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 2011
DOI: 
10.5262/tndt.2011.1002.10

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
IN TRODU CTION: Treatment of membranoproliferative glomerulonephritis (MPGN) is often unrewarding with approximately 60% of patients progressing to end-stage renal failure within 10 years. In our study, we compared the efficacy of CS alone versus low dose CS + another immunosuppressive agent retrospectively. MA TERIAL and M ETHODS: Twenty-nine patients (17 male) with MPGN were retrospectively grouped according to treatment protocols with CS (methylprednisolone 1mg/kg) (group 1, n=14); low dose CS + another immunosuppressive agent (group 2, n=15) [CS+MMF (n=6), CS+AZA (n=3), CS + CYC (n=6)]. Patients in all groups also received renin-angiotensin system (RAS) inhibitors. RESUL TS: All patients received treatment for 12 months. Remission occurred in 12 patients (85.7%) (9 complete and 3 partial) in group 1 and 10 patients (66.6%) (7 complete and 3 partial) in group 2 (p=0.316). No patients required dialysis within the one year of follow up complications. At one year of treatment the baseline proteinuria levels of patients in group 1 (5.83+2.91 g/day) and group 2 (5.37+4.05 g/day) significantly decreased to 0.21+0.42 g/day (p=0.005) and 1.92+3.31 g/day (p=0.037), respectively. In the first year of treatment mean glomerular filtration rate (GFR) values of patients in group 1 (105+40 mL/min) was significantly higher than the group 2 (66+23 mL/min) (p=0.005). CONCLU SION: There is no significant extra benefit in treating adult MPGN patients with combination therapy including low dose CS plus various immunosuppressive agents.
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Abstract (Original Language): 
GİRİŞ: Erişkinlerde membranoproliferatif glomerülonefritlerin (MPGN) yaklaşık %60’ı tedaviye karşın 10 yıl içinde son dönem böbrek yetersizliğine ilerlemektedir. Bu çalışmada, MPGN tedavisinde Kortikosteroid’in tek başına kullanımı ile düşük doz KS ile birlikte diğer bir immünsupresif ajan içeren kombinasyon tedavisi alan hastalar geriye dönük olarak karşılaştırıldı. GEREÇ ve YÖN TEML ER: MPGN’li 29 hasta (17 erkek) iki gruba ayrıldılar. Grup 1 (n=14), KS (metilprednisolon 1 mg/kg/gün) ve grup 2 (n=15) düşük doz KS+ diğer bir immünsupresif ajan [düşük doz KS+mikofenolat mofetil (MMF) (n=6), KS+azatioprin (AZA) (n=3), KS+siklofosfamid (CYC) (n=6)] tedavi grubuna ayrıldılar. BUL GULA R: Tüm hastalar 12 ay boyunca tedavi aldılar. Grup 1’de 12 hastada (%85,7; 9 tam ve 3 kısmi), grup 2’de 10 hastada (%66,6; 7 tam ve 3 kısmi) remisyon gözlendi (p=0,316). Bir yıl içinde hiçbir hastada diyaliz gereksinimi olmadı. Bir yıllık tedavinin sonunda grup 1 (5,83+2,91 g/gün) ve grup 2’nin (5,37+4,05 g/gün) bazal proteinüri düzeylerinde sırasıyla 0,21+0,42 g/gün (p=0,005) ve 1,92+3,31 g/gün (p=0,037) düzeylerine kadar anlamlı bir azalma gözlendi. Bununla birlikte, tedavinin birinci yılında grup 1’in GFH’si (105+40 mL/dak) grup 2’den (66+23 mL/dak) anlamlı derecede yüksek bulundu. SONU Ç: Yetişkin MPGN’li hastaların tedavisinde düşük doz KS tedavisi ile birlikte diğer immünsupresiflerden oluşan kombinasyon tedavilerinin tek başına KS tedavisi ile karşılaştırıldığında önemli bir üstünlüğü gözlenmedi.
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  • 2
173-177
  • Turkish

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