Efficacy of Tacrolimus Combined with Low-dose Prednisolone in Stage I Membranous Nephropathy

Objective To observe the efficacy and safety of the tacrolimus combined with lowdose prednisolone in stage Ⅰ membranous nephropathy.Methods Twenty patients diagnosed with stage Ⅰ membranous nephropathy by renal biopsy(excluding secondary renal disease)between March 2008 and January 2010 in the First Affiliated Hospital of Nanchang University were divided into two groups,with 10 patients in each group.The treatment group was given tacrolimus combined with low-dose prednisolone.The control group was treated with mycophenolate mofetil capsules combined with low-dose prednisolone.The 24-hour urinary protein excretion,serum albumin(Alb),aspartate aminotransferase(ALT),alanine aminotransferase(AST),serum creatinine(Scr),blood urea nitrogen(BuN)and white blood cell(WBC)count were determined before treatment and after treatment for 6and 12 months.The curative effects and adverse reactions were recorded after treatment for 6months and 12 months.Results No recurrence or repetition occurred in all patients.After treatment for 6and 12months,compared with control group,tacrolimus combined with low-dose prednisolone increased the total effective rate(70.0% and 80.0%vs 40.0%and 60.0%,respectively;P0.05),decreased 24-hour urinary protein excretion(P0.05),and raised serum Alb levels(P0.05).No obvious changes in levels of serum ALT,serum AST,serum creatinine and blood BuN and WBC count were observed after treatment in both groups(P0.05),and there was no significant difference in the incidence of adverse reactions between the two group(20.0%vs 20.0%,P0.05).Conclusion Compared with combined treatment with mycophenolate mofetil and low-dose prednisolone,tacrolimus combined low-dose prednisolone can alleviate disease condition,decrease adverse reactions and enhance safety in stage Ⅰ membranous nephropathy.