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Volume 11 Issue 3
May  2020
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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

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  • 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
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    • 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.
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    • References (12)
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