A Clinical Study on Tacrolimus Combined with Low Dose of Prednisone in Treating of StageI and II Membranous Nephropathy

Objective: To observe the efficacy and safety of tacrolimus combined with small dose of prednisone in treating patients with stage Ⅰand Ⅱ membranous nephropathy.Methods: Forty-seven patients who were diagnosed as membranous nephropathy by renal biopsy from January 2009 to December 2010 were divided into stageⅠmembranous nephropathy group(group Ⅰ,21 cases)and stage Ⅱ membranous nephropathy group(groupⅡ,26 cases)according to Ehrenreich and Churg staging methods.Therapeutic efficacy and adverse effects in the two groups were observed.Results: Average blood concentration of tacrolimus in groupⅠ was fluctuating between 5.04~8.50 μg/L in the couse of treatment,and that in group Ⅱwas fluctuating between 4.87~8.54 μg/L.Total remission rates of group Ⅰ and group Ⅱ were 81% and 46% respectively,and there was significant difference between the two groups(P0.05).The levels of 24-hour urinary protein(UP),triglyceride and cholestrol significantly decreased(P0.05)and albumin significantly increased(P0.05) in both the two groups after treatment for 12 months.UP levels of groupⅠin 3 months and 6 months after treatment were significantly lower than those of group Ⅱ(P0.05).Conclusions: The efficacy of tacrolimus combined with small dose of prednisone in treating of stageⅠand stage Ⅱmembranous nephropathy is good.Both complete remission rate and partial remission rate of groupⅠare higher than those of group Ⅱ.Adverse reactions in the two groups are not common,and there is no significant difference of adverse reactions between the two groups.