Leflunomide Therapy Versus Cyclophosphamide Treatment in Patients with Severe Children IgA Nephropathy

Objective To compare the clinical efficacy leflunomide(LEF)of with that of cyclophosphamide(CTX)in the treatment of severe IgA nephropathy.Methods Forty one patient s with severe IgA nephropathy were enrolled into this study and were divided into LEF and CTX groups.LEF group included 21 cases that were treated with LEF at a dosage of 1mg/kg(≤40mg)for 3 days,then 0.5mg/kg(≤20mg)for 6 months.CTX group enrolled 20 cases that were givenintravenous drip 8～12mg/kg 2d per 2 weeks,and the total dosage was less than 150mg/kg.The patient s were followed up for more than 12 months.The clinical efficacy andside effect s were compared between the two groups.Results ①Clinical remission rate in the 12th month was 90.4%in LEF therapy and it was 60.0% in CTX group.The difference of the clinical remission rate between the two groups was significan(tP0.05).②The concentration of proteinuria in 24 h in LEF group was lower than that in CTX group(P0.05).③After the therapy,the level of blood 2 lipid decreasedobviously in LEF group,but it did not changed in CTX group(P0.05).④The side effect in both groups were 9.5%(LEF group)vs 40%(CTX group)(P0.05).Conclusion The combination therapy of LEF and steroid was more effective than CTX intravenous drip in treatmentof severe IgA nephropathy and has fewer side effects.