Observation on curative effects of leflunomide combined with glucocorticoids in the treatment of refractory nephrotic syndrome

Abstract

Objective To investigate the efficacy of leflunomide combined with glucocorticoids in the treatment of refractory nephrotic syndrome.Methods In our hospital from January 2009 to January 2012,we selected 80 patients with renal biopsy diagnosis of refractory nephrotic syndrome as research subjects,according to different treatment they were divided into observation group and control group,40 cases in each group,and two groups were treated with oral prednisone,the observation group on the basis of the prednisone treatment was given leflunomide treatment,the efficacy was compared between two groups,and then observed 24 h urinary protein,serum albumin (ALB),serum creatinine (Scr) and blood urea nitrogen (BUN) changes after treatment of 4 weeks,12 weeks and 24 weeks,and recorded adverse reactions during treatment.Results The patients of two groups after treatment of 24 weeks,efficacy evaluation showed that the rote of complete remission of the observation group and control group a significant response rate,partial response rate and the total effective rate were compared between the two groups with no statistical significant differenee (P＞0.05).After treatment for 4 weeks,compared with those before treatment,24 h urinary protein,Scr were significandy lower,serum albumin was significantly higher,the difference was staistically significant (P＜0.05); BUN of the observation group and control group patients decreased significandy after treatment for 12 weeks,respectively,the difference was significant (P＜0.05); after treatment for 24 weeks,the above indicators,compared with those after treatment of 12 weeks,showed the significant difference (P＜0.05),and observation group improved more significantly than control group (P＜0.05).Conclusion Leflunomide combined hormone treatment of refractory nephrotic syndrome is safe and effective,with less adverse reaction,which is worthy of wider promotion and application,but tbe study did not extend the course of clinical observation in alleviating cases,therefore,it is recommended that its long-term efficacy,long-term prognosis and adverse reaction remains to be exploted by further in-depth research. Key words: Refractory nephrotic syndrome; Leflunomide; Glucocorticoids