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The two features — presentation after several months of onset of symptoms and difficulty in completing treatment, are common for the majority in a developing country.

Chronic kidney disease - causes, symptoms, diagnosis, treatment, pathology

The side effects of the steroids and cyclophosphamide were Ponticelli et al. Ten percent of treated patients had to stop therapy because of side effects, and all patients recovered after adequate therapeutic measures. No immunosuppression was given. The probability of dialysis free survival in our study was Idiopathic membranous nephropathy: Outline and rationale of a treatment strategy.

Am J Kidney Dis. The eGFR, using the 6-variable Modification of Diet in Renal Disease had suggested the presence of renal impairment at the onset of study. It highlights that the patients in the present study also had similar renal impairment and had shown favorable results with steroids and cyclophosphamide therapy.

Other investigators have regularly used serum creatinine values to define renal function.

It is now realized that the often used threshold value of 1. The use of serum creatinine level as a marker of glomerular filtration rate was problematic in patients with nephrotic syndrome, as it was observed that the creatinine secretion was increased in patients with nephrotic syndrome, thus leading to marked overestimation of GFR. Serum creatinine is a poor marker of GFR in nephrotic syndrome. It suggested that our patients were in chronic kidney disease stage 2.

Patients in the present study, therefore, represented a group who progressed to renal impairment before they received a definitive treatment.

Oxford Textbook of Clinical Nephrology

Idiopathic membranous nephropathy. Kid Int Suppl. The long-term value of renin angiotensin system blockade in the management of IMN has been assessed largely by observational studies. Immunosuppressive treatment for idiopathic membranous nephropathy: A systematic review.

Controlled trial of cyclophosphamide in idiopathic membranous nephropathy. Randomized controlled trial of cyclophosphamide, warfarin and dipyridamole in idiopathic membranous glomerulonephritis. Clin Nephrol. Therapy of membranous glomerulonephritis with nephrotic syndrome: 5 Years follow-up of a prospective randomized multi-center study.

Clinical Study

The limitations of this study were: 1 only It was not done because patients were in medium risk of progression. The standard deviations in the Table 1 depict the lack of dispersion of the 24 hour urine protein values in patients. These patients might have influenced the outcome negatively.

The present study was not an ideal trial, but in a real life practice in a developing country conditions induce delayed presentation, irregular follow-up and drop out. The main messages of the study were: long-term follow-up studies were required to understand the effect of treatment of IMN.

The remission rates after 10 years of steroids and cyclophosphamide was lower than initial remission rates.


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The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper. Skip to Main Content. Search in: This Journal Anywhere. Advanced search. Journal Renal Failure Volume 37, - Issue 3. Submit an article Journal homepage.


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Pages Received 06 Sep Clinical Study. A year follow-up of idiopathic membranous nephropathy patients on steroids and cyclophosphamide: a case series. Abstract The studies of idiopathic membranous nephropathy IMN require sufficiently long duration of follow-up to understand the effect of treatment on the development of end-stage renal disease ESRD in IMN. Introduction Idiopathic membranous nephropathy IMN is the most common cause of nephrotic syndrome in adults. Treatment Patients received a 6-month course of alternate months of steroids and cyclophosphamide.

Follow-up During treatment with steroids and cyclophosphamide, the patients were seen once a month. Results A total of 58 IMN patients were recruited from to A year follow-up of idiopathic membranous nephropathy patients on steroids and cyclophosphamide: a case series All authors. Published online: 28 April Table 1. Table 2.

Anti-glomerular basement membrane antibody disease treated with rituximab: A case-based review. Semin Arthritis Rheum ; Rituximab in anti-GBM disease: A retrospective study of 8 patients. Recurrence of glomerulonephritis after renal transplantation. Transplant Rev Orlando ; Arthritis Rheum ; Genetically distinct subsets within ANCA-associated vasculitis. ANCA-associated vasculitides-advances in pathogenesis and treatment. Nat Rev Rheumatol ; Pathogenesis and treatment of ANCA-associated vasculitides.

Clin Exp Rheumatol ;S Pathogenesis of antineutrophil cytoplasmic autoantibody-mediated disease. Neutrophil extracellular traps can activate alternative complement pathways. Clin Exp Immunol Mol Immunol ; Antineutrophil cytoplasmic autoantibodies specific for myeloperoxidase cause glomerulonephritis and vasculitis in mice.

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Curr Med Chem ; Renal participation of myeloperoxidase in antineutrophil cytoplasmic antibody ANCA -associated glomerulonephritis. New mechanism for glomerular injury. Myeloperoxidase-hydrogen peroxide-halide system. What is myeloperoxidase doing in ANCA-associated glomerulonephritis? Molecular mimicry in pauci-immune focal necrotizing glomerulonephritis.

Table of Contents

Nat Med ; Anti-LAMP-2 antibodies are not prevalent in patients with antineutrophil cytoplasmic autoantibody glomerulonephritis. Epitope specificity determines pathogenicity and detectability in ANCA-associated vasculitis. New insights that link microbes with the generation of antineutrophil cytoplasmic autoantibodies: the theory of autoantigen complementarity. Curr Opin Nephrol Hypertens ; Treatment of ANCA-associated vasculitis: new therapies and a look at old entities. Adv Chronic Kidney Dis ; Can antineutrophil cytoplasmic antibody levels be used to inform treatment of pauci-immune vasculitis?

Primary IgA nephropathy: current challenges and future prospects

Curr Opin Rheumatol ; ANCA as a predictor of relapse: useful in patients with renal involvement but not in patients with nonrenal disease. Brief report: The value of a patient global assessment of disease activity in granulomatosis with polyangiitis Wegener's. Arthritis Rheumatol ; Cyclophosphamide therapy in Wegener's granulomatosis. Effect of cyclophosphamide upon the immune response in Wegener's granulomatosis.

Risk factors for relapse of antineutrophil cytoplasmic antibody-associated vasculitis. Pulse versus daily oral cyclophosphamide for induction of remission in antineutrophil cytoplasmic antibody-associated vasculitis: a randomized trial. Pulse versus daily oral cyclophosphamide for induction of remission in ANCA-associated vasculitis: long-term follow-up. Nephrol Dial Transplant ;i1-i7. Rituximab versus cyclophosphamide for ANCA-associated vasculitis.