Email Alert RSS
Volume 11 Issue 3
May  2020
Turn off MathJax
Article Contents
Abstract
References
Related Articles
Huai-ya XIE, Chao LI, Yu-bing WEN, Wei YE, Jian-fang CAI, Hang LI, Xue-mei LI, Xue-wang LI. Efficacy and Prognosis of Calcineurin inhibitors and Cyclophosphamide in Treating Idiopathic Membranous Nephropathy in Patients with Type 2 Diabetes[J]. Medical Journal of Peking Union Medical College Hospital, 2020, 11(3): 296-300. DOI: 10.3969/j.issn.1674-9081.20180463
Citation: Huai-ya XIE, Chao LI, Yu-bing WEN, Wei YE, Jian-fang CAI, Hang LI, Xue-mei LI, Xue-wang LI. Efficacy and Prognosis of Calcineurin inhibitors and Cyclophosphamide in Treating Idiopathic Membranous Nephropathy in Patients with Type 2 Diabetes[J]. Medical Journal of Peking Union Medical College Hospital, 2020, 11(3): 296-300. DOI: 10.3969/j.issn.1674-9081.20180463
shu

Efficacy and Prognosis of Calcineurin inhibitors and Cyclophosphamide in Treating Idiopathic Membranous Nephropathy in Patients with Type 2 Diabetes

  • 1.

    Department of Internal Medicine,Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China

  • 2.

    Department of Nephrology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China

More Information
  • Corresponding author:

    CAI Jian-fang Tel:86-10-69155058,E-mail:caijfbj@126.com

  • Received Date: December 19, 2018
  • Issue Publish Date: May 29, 2020
    Graphical Abstract
    • Abstract
  •   Objective  The aim of this study was to compare the efficacy and prognosis of different therapeutic regimens in treating idiopathic membranous nephropathy (IMN) in patients with type 2 diabetes.
      Methods  The clinical data were retrospectively collected and analyzed in patients with IMN and type 2 diabetes admitted in the Peking Union Medical College Hospital from January 2004 to April 2015. The patients were classified into three groups and designated as cyclophosphamide (CTX), calcineurin inhibitors (CNIs)and other immunosuppressants groups according to the initial therapeutic regimens. Kaplan-Meier analysis and multivariable Cox regression were used to assess the influence of therapeutic regimens on total remission (TR), complete remission (CR), risks of developing ≥ 30% decline in estimated glomerular filtration rate (eGFR) or end-stage renal disease (ESRD), and risks of achieving fast blood glucose >8 mmol/L.
      Results  Totally, 89 patients meeting the inclusive and exclusive criteria were included in this study. The multivariable Cox analysis showed that patients initially treated with CNIs would be significantly higher to develop ≥ 30% eGFR decline or ESRD (HR=13.505, 95% CI:1.512-120.665, P=0.020) than those treated with CTX. However, the likeliness to reach CR(HR=0.793, 95% CI:0.315-1.999, P=0.623), TR(HR=0.647, 95% CI:0.334-1.252, P=0.196), or fast blood glucose >8 mmol/L (HR=1.709, 95% CI:0.669-4.369, P=0.263) were similar between the two groups.
      Conclusions  In patients with type 2 diabetes, CNIs as the initial treatment for IMN might have comparable remission rate of proteinuria with CTX, but an extra risk of renal function decline. We would better be cautious in choosing the therapeutic regimens to treat IMN in patients with type 2 diabetes.
    • FullText(HTML)
    • References (12)
  • [1]
    中国医学会糖尿病学分会. 中国2型糖尿病防治指南(2017年版)[J]. 中国糖尿病杂志, 2018, 10:4-67.
    [2]
    Grujicic M, Salapura A, Basta-Jovanovic G, et al. Non-diabetic kidney disease in patients with type 2 diabetes mellitus-11-year experience from a single center[J]. Med Arch, 2019, 73:87-91. DOI: 10.5455/medarh.2019.73.87-91
    [3]
    Horvatic I, Tisljar M, Kacinari P, et al. Non-diabetic renal disease in Croatian patients with type 2 diabetes mellitus[J]. Diabetes Res Clin Pract, 2014, 104:443-450. DOI: 10.1016/j.diabres.2014.03.016
    [4]
    Chapter 7:Idiopathic membranous nephropathy[J]. Kidney Int Suppl(2011), 2012, 2:186-197.
    [5]
    Chen Y, Schieppati A, Chen X, et al. Immunosuppressive treatment for idiopathic membranous nephropathy in adults with nephrotic syndrome[J]. Cochrane Databases Syst Rev, 2014, (10):CD004293. https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0012676/
    [6]
    American Diabetes Association. Standards of medical care in diabetes——2011[J]. Diabetes Care, 2011, 34 Suppl 1:S11-S61. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=PubMed000002346022
    [7]
    邹万忠. 肾活检病理诊断指导意见[J]. 中国肾脏病杂志, 2001, 17:270-275.
    [8]
    Levey AS, Stevens LA, Schmid CH, et al. A new equation to estimate glomerular filtration rate[J]. Ann Intern Med, 2009, 150:604-612. DOI: 10.7326/0003-4819-150-9-200905050-00006
    [9]
    Chapter 2:General principles in the management of glomerular disease[J]. Kidney Int Suppl(2011), 2012, 2:156-162.
    [10]
    Qiu TT, Zhang C, Zhao HW, et al. Calcineurin inhibitors versus cyclophosphamide for idiopathic membranous nephropathy:A systematic review and meta-analysis of 21 clinical trials[J]. Autoimmun Rev, 2017, 16:136-145. DOI: 10.1016/j.autrev.2016.12.005
    [11]
    Howman A, Chapman TL, Langdon MM, et al. Immunosuppression for progressive membranous nephropathy:a UK randomised controlled trial[J]. Lancet, 2013, 381:744-751. DOI: 10.1016/S0140-6736(12)61566-9
    [12]
    Coresh J, Turin TC, Matsushita K, et al. Decline in estimated glomerular filtration rate and subsequent risk of end-stage renal disease and mortality[J]. JAMA, 2014, 311:2518-2531. DOI: 10.1001/jama.2014.6634
    • Related Articles

  • Related Articles

    [1]YAN Xinchun, HUO Li. Evaluation of Von Hippel-Lindau Syndrome Through Novel Small Molecular Tracer 68Ga-NY104 PET/CT Imaging[J]. Medical Journal of Peking Union Medical College Hospital, 2024, 15(4): 911-915. DOI: 10.12290/xhyxzz.2024-0216
    [2]LUO Fuchao, ZHANG Junhua, CHENG Peng, WU Jing, ZHONG Bin, LYU Bing, HUANG Guogang, LIU Yang, ZHANG Zexue, WEI Xiaohong. Clinical Application of Ultrasound-guided RISS Plane Block for Postoperative Analgesia After Minimally Invasive McKeown Esophagectomy: A Prospective Randomized Controlled Study[J]. Medical Journal of Peking Union Medical College Hospital, 2024, 15(3): 624-631. DOI: 10.12290/xhyxzz.2023-0358
    [3]HUANG Lu, WU Youbin, NI Yiran, LIU Mengyuan, WU Jiangfeng, ZHANG Yanqiong. The Mechanism of miRNAs in Liver Fibrosis[J]. Medical Journal of Peking Union Medical College Hospital, 2023, 14(6): 1251-1257. DOI: 10.12290/xhyxzz.2023-0125
    [4]LIU Yuan, ZHAO Lin. Update and Interpretation of 2022 National Comprehensive Cancer Network Clinical Practice Guidelines for Gastric Cancer[J]. Medical Journal of Peking Union Medical College Hospital, 2022, 13(6): 999-1004. DOI: 10.12290/xhyxzz.2022-0271
    [5]Yuan XIA, Xiang-pei LI. The Role of MicroRNA Regulation of Interferon-α in the Pathogenesis of Systemic Lupus Erythematosus[J]. Medical Journal of Peking Union Medical College Hospital, 2019, 10(6): 673-678. DOI: 10.3969/j.issn.1674-9081.2019.06.021
    [6]Xiao-yun ZHANG, Jian-yu HAO. PTEN and Digestive Organ Fibrosis[J]. Medical Journal of Peking Union Medical College Hospital, 2017, 8(4-5): 300-304. DOI: 10.3969/j.issn.1674-9081.2017.05.020
    [8]Ming-sheng MA, Xü-de ZHANG, Min WEI, Shi-min ZHAO, Zheng-qing QIU. Efficacy of Low Dose Corticosteroid Therapy in Duchenne Muscular Dystrophy[J]. Medical Journal of Peking Union Medical College Hospital, 2014, 5(4): 384-388. DOI: 10.3969/j.issn.1674-9081.2014.04.006
    [9]Yu-mei JIN, Feng-rong AI, Yan LUO, Ying LI. Comparison of Central Corneal Thickness Before and After Mydriasis Measured with A-ultrasound Pachymetry and Pentacam Scheimpflug System[J]. Medical Journal of Peking Union Medical College Hospital, 2013, 4(4): 429-432. DOI: 10.3969/j.issn.1674-9081.2013.04.017
    [10]Shuai TANG, Jie YI, Yu-guang HUANG. Cardiovascular Responses of Intubation with Shikani Seeing Optical Stylet and Macintosh Laryngoscope[J]. Medical Journal of Peking Union Medical College Hospital, 2012, 3(3): 314-317. DOI: 10.3969/j.issn.1674-9081.2012.03.015

  • Cited by

    Periodical cited type(2)

    1. 王宪沛，高传玉，李牧蔚，张优，孙玉晓，鲁平，赵秋平，齐大屯，王山，戴国友，倪占玲，张丽华，赵玉兰，张振香，张辉，张金盈，赵洛沙，刘新灿，王霞. 心脑血管病共同危险因素评估、检测及干预的专家共识. 中华实用诊断与治疗杂志. 2021(06): 541-551 .
    2. 方玲，黄惠萍，杨珍珍，郭祈福，吴华. 便携式血脂仪与全自动生化仪检测卒中患者低密度脂蛋白胆固醇的比对分析. 福建医科大学学报. 2020(01): 23-28 .

    Other cited types(0)

Catalog

    Get Citation
    PDF
    XML

    Article Metrics

    Article views (449) PDF downloads (223) Cited by(2)
    Related
    Address：Room 302,Third Floor,Building 7, No. 1 Shuaifuyuan, Wangfujing, Dongcheng District, Beijing 100730, China
    Tel：010-69154261/4262
    E - mail：medj@pumch.cn mjpumch@126.com
    Copyright of website：Editorial Office of Medical Journal of Peking Union Medical College Hospital

      Supported by: Beijing Renhe Information Technology Co., Ltd.  Baidu Analytics

      /

      DownLoad:  Full-Size Img  PowerPoint
      Return
      Return
      x Close Forever Close