Comparison on the Therapeutic Effect of Cyclosporin A and Cyclophosphamide in the Treatment of Idiopathic Membranous Nephropathy

Objective:To compare the efficacy and safety of cyclosporin A (CSA) and cyclophosphamide (CTX) combined hormone in the treatment of Idiopathic membranous nephropathy(IMN).Methods:76 patients with primary nephrotic syndrome were diagnosed by renal biopsy in IMN,excluded in the diagnosis of secondary membranous nephropathy,alone or relapsed hormone therapy,were randomly divided into two groups to CSA combined with glucocorticoid treatment (CSA group) or CTX combined with glucocorticoid treatment (CTX group),treatment for at least 12 months.To observe 24 h urinary protein,serum albumin,renal function,blood glucose,WBC and its side effects in each group,and complete response rates before and after treatment,partial remission rate.All patients entered the study and treatment in a formal or disabled without using steroids and cytotoxic drugs for six months or more.Results:Treatment after 3 months,CsA group,24 hours urine protein,cholesterol,triglycerides were significantly lower than the CTX group (P all 0.01),serum albumin was significantly higher than the CTX group (P0.01).Comparison of two groups of serum creatinine in patients with no significant difference (P0.05),while the CTX group,WBC was significantly lower than CsA group (P0.01).CsA complete remission rate was significantly higher than that of CTX group (χ2=4.631 7,P0.05).The end of the treatment of 12 complete remission rate in both groups no significant difference (χ2=1.257 5,P0.05).CsA group,the incidence of adverse reactions (8/40=20.0%) was significantly lower than the CTX group (15/36=41.7%) (χ2=4.214 6,P0.05).Conclusion:Compared with CTX,CsA combined with glucocorticoid treatment for 12 months on the IMN overall efficacy equivalent,but CsA faster onset,better curative effect,less adverse reactions.CsA≤5 mg·kg-1·d-1) for the IMN patients with normal renal function is safe and effective.