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      Relapsing Membranous Nephropathy

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          Background: Although controversial, treatment of membranous nephropathy appears to yield a reduction in the degree of proteinuria and conservation of renal function. Methods: We report herein our experience with the treatment with steroids alone (group II, n = 13), or in combination with immunosuppressants (group III, n = 19) of patients with membranous nephropathy and the nephrotic syndrome, with a mean follow-up of 8.37 years. Results: All patients underwent a first remission, with 24-hour urine protein excretion falling to 0.63 ± 0.25 g in group II and 0.62 ± 0.26 g in group III (p = NS) after 12.69 ± 10.94 months of treatment in group II and 18.95 ± 13.17 months in group III (p = NS). Three patients from group II (23%) and seven patients from group III (36.8%) experienced four and eight relapses, respectively (proteinuria in 24 h 4.0 ± 0.80 g in group II relapsers and 4.4 ± 0.87 in group III relapsers; p = NS). On treatment, all relapses remitted (second remission) after 7 ± 6.93 months of therapy for group II and 8.6 ± 6.70 months of treatment for group III (p = NS). Thereafter, no patients from group II, but 3 patients from group III (33.3%) had a second relapse. After treatment, all relapses remitted (third remission) in 3.3 ± 1.53 months of therapy. Conclusions: These studies show that relapses, which occur in one-third of patients, respond favorably to treatment albeit remitting in approximately half the time, and that the duration of remission gets progressively longer in the later compared to the earlier remission.

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          Author and article information

          Am J Nephrol
          American Journal of Nephrology
          S. Karger AG
          August 1999
          13 August 1999
          : 19
          : 4
          : 474-479
          Renal Section, Department of Medicine, Baylor College of Medicine, and The Methodist Hospital, Houston, Tex., USA
          13501 Am J Nephrol 1999;19:474–479
          © 1999 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

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          Figures: 2, Tables: 2, References: 19, Pages: 6
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