Analysis of different treatments and their outcomes in idiopathic membranous nephropathy: a single-center observational study

Abstract

Background Although there are multiple treatment modalities for idiopathic membranous nephropathy (IMN) which have been studied in different streams of populations, there is no single convincing answer for the best accepted modality. In the study presented, we have made an effort to compare the different treatment regimens and analyze the results obtained. Patients and methods This was a retrospective observational study. A total number of 54 patients with idiopathic membranous nephropathy were included in the study. Five different treatment groups were made, which included modified Ponticelli regime, oral cyclophosphamide, oral mycophenolate mofetil, oral tacrolimus, and intravenous rituximab therapy, and were followed up for 1 year. Urine protein to creatinine ratio, serum albumin, creatinine, and estimated glomerular filtration rate were noted at 1, 3, 6, 9, and 12 months. Results Among the 54 patients, 10 of 16 patients in modified Ponticelli group, 9 of 18 in oral cyclophosphamide group, 4 of 9 in oral mycophenolate mofetil group, 3 of 6 in oral tacrolimus group, and 3 of 5 in intravenous rituximab group achieved remission. There was statistically significant improvement in renal function in modified Ponticelli group (P=0.02) and oral cyclophosphamide group (P=0.01) as compared with the other groups. Conclusion Patients who received modified Ponticelli regime had superior outcomes in terms of improvement in renal function and renal survival as compared with other different therapies. Large studies with long-term follow ups are needed to support the outcome.