The long-term therapeutic effects of two ponticelli methods in the treatment of idiopathic membranous nephropathy

Abstract

Objective To investigate the long-term clinical effects of two ponticelli methods in the treatment of idiopathic membranous nephropathy. Methods All 88 patients of idiopathic membranous nephropathy were divided into two groups according to different methods. One group(n=40) received oral therapy of CTX(100 mg/d, cumulative dose 8~10 g), and another group(n=40) were treated with monthly intravenous therapy of CTX(0.8~1.0 mg/d, cumulative dose 8~10 g). All patients received treatment of metacortandracin, which was gradually reduced during 8~12 weeks. At the end of study, the clinical remission rate, complication rate, recurrence rate and lost rate were evaluated in two groups. Results Compared with the oral CTX group, the clinical remission rate was decreased for 3 months in intravenous CTX group(10% vs. 6%, P<0.05), and the peak value of remission rate was 12 months. The side-effect of recurrence rate, lost rate and low white blood cell count in oral group were higher than intravenous CTX group(P<0.05). Conclusions The early clinical remission rate is better in oral group, however, there is no difference on the long-term clinical effect between two groups. In a word, the combination of CTX and metacortandracin is for IMN patients. Moreover, compared with the intravenous CTX group, the complication rate, recurrence rate and lost rate are higher than oral CTX group.The therapy of oral CTX may be more security, however, more studies of long-term observation are needed to make the evidence stronger. Key words: Glomerulonephritis, Membranous; Prednisone