Complete remission induced by tacrolimus and low-dose prednisolone in adult minimal change nephrotic syndrome: A pilot study
Kidney Research and Clinical Practice
;
: 112-117, 2012.
Article
in English
| WPRIM
| ID: wpr-174798
ABSTRACT
BACKGROUND:
Few clinical trials have examined the replacement of steroids with other immunosuppressive drugs as a primary treatment modality for minimal change disease (MCD) in adults. We studied the efficacy of tacrolimus to induce complete remission (CR) in adults with MCD.METHODS:
We enrolled 14 adults with MCD and nephrotic-range proteinuria. All patients were treated with oral tacrolimus 0.05mg/kg twice daily and prednisolone 0.5mg/kg/day. CR was defined as a urine protein to creatinine ratio of<0.2g protein/g creatinine (g/g cr). The primary outcome was cumulative percentage of CR during 16 weeks.RESULTS:
The mean urine protein to creatinine ratio at enrollment was 10.9g/g cr (range 4.2-18.1g/g cr). The trough tacrolimus level was maintained at 5.99+/-2.63ng/mL. CR was achieved by 13/14 (92.8%) patients within 8 weeks. The cumulative CR rate was 7.7% (1/14), 64.2% (9/14), 71.3% (10/14), and 92.9% (13/14) at 1 week, 2 weeks, 4 weeks, and 8 weeks, respectively. The one remaining patient achieved CR at 20 weeks after treatment, who was followed up for a further 4 weeks. The mean time to achieve CR in the 14 patients was 4.64+/-5.11 (1-20) weeks. Three cases suffered adverse events of abdominal pain, diarrhea, or new-onset diabetes mellitus.CONCLUSION:
Tacrolimus and low-dose prednisolone therapy induced CR rapidly (71.3% by 4 weeks and 100% by 20 weeks) and effectively in adult patients with MCD.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Proteinuria
/
Steroids
/
Prednisolone
/
Abdominal Pain
/
Pilot Projects
/
Corneal Dystrophies, Hereditary
/
Tacrolimus
/
Creatinine
/
Diarrhea
/
Nephrosis, Lipoid
Limits:
Adult
/
Humans
Language:
English
Journal:
Kidney Research and Clinical Practice
Year:
2012
Type:
Article
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