Study of mizoribine therapy in elderly patients with membranous nephropathy: comparison with patients not receiving mizoribine

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• 作者：Takafumi Ito ; Kaori Mochizuki ; Tomohiro Oka…
• 关键词：Elderly patients ; Membranous nephropathy ; Mizoribine ; Steroid
• 刊名：International Urology and Nephrology
• 出版年：2015
• 出版时间：January 2015
• 年：2015
• 卷：47
• 期：1
• 页码：131-135
• 全文大小：236 KB
• 参考文献：1. Yokoyama H, Taguchi T, Sugiyama H, Sato H, on behalf of the Committee for the Standardization of Renal Pathology Diagnosis and for Renal Biopsy and Disease Registry in the Japanese Society of Nephrology (2012) Membranous nephropathy in Japan: analysis of the Japan Renal Biopsy Registry (J-RBR). Clin Exp Nephrol 16:557-63 CrossRef
  2. Yokoyama H, Sugiyama H, Sato H et al (2012) Renal disease in the elderly and the very elderly Japanese: analysis of the Japan Renal Biopsy Registry (J-RBR). Clin Exp Nephrol 16:903-20 CrossRef
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  4. Ito T, Mochizuki K, Fukunaga N, Nakanishi N, Hanada M, Hanada K (2012) Study of mizoribine therapy for elderly nephropathy patients. J New Rem Clin 61(3):480-85 (article in Japanese)
  5. Koshikawa S, Satoh M, Narita M, Sakai O, Nakajima M (1993) Clinical evaluation of an immunosuppressive drug, mizoribine (HE-69) on steroid-resistant nephrotic syndrome—a multicenter double-blind comparison study with placebo. Kidney Dial 4:631-50 (article in Japanese)
  6. Kikuchi Y, Imakiire T, Yamada M, Saigusa T, Hyodo T, Hyodo N et al (2005) Mizoribine reduces renal injury and macrophage infiltration in non-insulin-dependent diabetic rats. Nephrol Dial Transplant 20(8):1573-581 CrossRef
  7. Irie F, Iso H, Sairenchi T, Fukasawa N, Yamagishi K, Ikehara S et al (2006) The relationships of proteinuria, serum creatinine, glomerular filtration rate with cardiovascular disease mortality in Japanese general population. Kidney Int 69:1264-271 CrossRef
  8. Matsumoto Y, Shimada Y, Nojima Y, Moriki T (2013) Efficacy of mizoribine followed by low-dose prednisone in patients with idiopathic membranous nephropathy and nephrotic-range proteinuria. Ren Fail 35:936-41 CrossRef
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  11. Saito T, Iwano M, Matsumoto K, Mitarai T et al (2013) Significance of combined cyclosporine–prednisolone therapy and cyclosporine blood concentration monitoring for idiopathic membranous nephropathy with steroid-resistant nephrotic syndrome: a randomized controlled multicenter trial. Clin Exp Nephrol. doi:10.1007/s10157-013-0925-2
  12. Wen M, Küchle C, Sarkar O, Renders L, Heemann U, Schmaderer C (2014) Plasmapheresis combined with rituximab for refractory idiopathic membranous nephropathy. Int Urol Nephrol 46(4):847-48 CrossRef
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• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Nephrology
  Urology and Andrology
  
• 出版者：Springer Netherlands
• ISSN：1573-2584

文摘

Background We have previously reported the results of mizoribine (MZR) treatment for elderly patients with membranous nephropathy (MN). Here, we retrospectively compared these patients with those who had been initially treated with prednisolone (PSL) alone. Methods The subjects were patients with MN aged ?5?years who were examined between April 2007 and September 2010 and followed for at least 1?year. Results The median period until the start of treatment in the MZR group (MZR-G) was 60?days. The urinary protein level at the start of MZR treatment was 3.89?±?2.3?g/gCr. Urinary protein in the group not treated with MZR (N-MZR-G) was 1.0?±?1.1?g/gCr, showing a tendency to improve in patients with nephrotic syndrome relative to the MZR-G (p?=?0.055). The PSL dose in the MZR-G versus N-MZR-G at 1?year was 5.7?±?3.0 versus 6.25?±?2.5?mg/day, the urinary protein level was 0.19?±?0.2 versus 0.13?±?0.1?g/gCr, and the remission rate was 80 versus 75?%. In the MZR-G, the total PSL dose at 1?year after the start of MZR treatment was 5,058?±?1,904 versus 6,649?±?875?mg in the N-MZR-G. Adverse events occurred in 3/5 patients (60?%) in the MZR-G and in 3/4 patients (75?%) in the N-MZR-G. Conclusion Elderly patients with MN who respond poorly to PSL treatment may be treated successfully with MZR.