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KONVANSÎYONEL ÎMMUNOSUPRESÎF TEDAVİYE YANITSIZ PRÎMER GLOMERULONEFRİT OLGULARINDA SİKLOSPORİN A TEDAVİSİNİN ETKİNLİĞİ

THE EFFICACY OF CYCLOSPORIN A TREATMENT IN CASES WITH PRIMARY GLOMERULONEPHRITIS THAT ARE UNRESPONSIVE TO CONVENTIONAL IMMUNSUPRESSIVE THERAPY

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 1999

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Immune system activation play an important role in the pathogenesis of primary glomerulonephritis. Although various immunsupressive agents have been used in the treatment of primary glomerulonephritis, still there is not an efficacious therapy model. In this study we aimed to investigate the efficacy of cyclosporin A on primary glomerulonephritis patients who did not respond to conventional immunsupressive therapy. Eleven Membranous glomerulonephritis (MGN), 6 Focal segmental glomerulosclerosis (FSGS), 4 Membranoproliferative glomerulonephritis (MPGN) and 4 Minimal change disease (MCD) total 25 patients were studied. Despite the treatment of prednisolone, prednisolone + cyclophosphamide or prednisolone + azathioprine at least for six months, persistance of proteinuria or progressive renal function loss accepted as resistance to therapy. Cyclosporin A 5 mg/kg +10 mg prednisolone was given at least for six months to these conventional therapy resistant patients. We compared urea, creatinine, creatinine clearance, proteinuria, serum total protein and serum albumin levels at the beginning of conventional therapy; at the end of conventional therapy = beginning of cyclosporin A and at the end of cyclosporin A treatment. Seven (%28) patients complete remission, 9 (%36) patients partial remission and 9 (%36) patients considered failure to cyclosporin A treatment. Complete or partial remission was observed in 7of 11 (%63) MGN patients. These results indicate that; cyclosporin A might be an alternative therapy model for primary glomerulonephritis patients that are resistant to conventional therapy.
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Abstract (Original Language): 
Primer glomerulonefr itlerin patogenezinde immun sistem aktivasyonu önemli bir rol oynamaktadır ancak bu hastalıkların tedavisinde çeşitli immunsupresifler kullanılmasına rağmen halen etkin bir tedavi modeli yoktur. Bu çalışmada konvansiyonel immunosupresif tedaviye yanıt vermeyen primer glomerulopati olgularında siklosporin A tedavisinin etkinliğini araştırmayı amaçladık. Çalışmaya 11 Membranöz Glomerulonefht (MGN), 6 Fokal Segmental Glomeruloskleroz (FSGS) 4 Membranoproliferatif Glomerulonefrit (MPGN), 4 Minimal Değişiklik Hastalığı (MDH) toplam 25 olgu alındı. En az altı ay olmak üzere prednizolon, prednizolon + azatioprin ya da prednizolon + siklofosfamid tedavisine rağmen persistan proteinüri veya ilerleyici renal fonksiyon kaybı tedaviye dirençli olarak kabul edildi. Bu konvansiyonel tedaviye dirençli olgulara 5 mg/kg siklosporin A + 10 mg prednizolon tedavisi uygulandı. Olguların ilk konservatif immunsupresif tedaviye başlangıç; konvansiyonel tedavi sonu = siklosporin-A tedavisi başlangıcı ve siklosporin-A tedavisi sonundaki üre, kreatinin, kreatinin klirensi, 24 saatlik proteinüri, serum total protein ve albumin seviyeleri karşılaştırıldı. Yedi (% 28) olguda tam remisyon,9 (% 36) olguda kısmi remisyon ve 9 (% 36) olguda ise siklosporin-A tedavisi sonucunda da tedaviye herhangi bir yanıt alınamadı, 11 MGN olgusunun 7 sinde (%63) komplet veya par siy el yanıt gözlendi. Sonuç olarak konvansiyonel tedaviye dirençli primer glomerulonefritlerde siklosporin A 'nın alternatif bir tedavi seçeneği olarak kullanılabileceği kanaatine varıldı.
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  • 1
19-72
  • Turkish

REFERENCES

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