The effect of tacrolimus combined with small dose of hormone on idiopathic membranous nephropathy

Objective To observe therapeutic effect and safety of tacrolimus on idiopathic membranous nephropathy(IMN)with nephrotic syndrome in different courses of treatment.Methods Twenty patients with nephritic syndrome caused by idiopathic membranous nephropathy were divided into short-term(10 cases)and long-term(10 cases)groups randomly.Short-term group and long-term group were treated with tacrolimus and prednisone for 6 months and 24 months repectively,then obersve treatment effect,concentration changes of tacrolimus,recurrence and side effects in 2 groups.Results Five patients obtained complete remission after 6 months of treatment in the short-term group;4 patients obtained partial remission;1 patient had no response.Average concentration of tacrolimus remained 5～7 μg/L in the period of treatment,and 6 cases recurred.Six patients obtained complete remission and 3 patients obtained partial remission after 24 months of treatment in the long-term group;1 patient had no response.Concentration of tacrolimus in the long-term group remained same as the short-term group at 5～8 μg/L at 6 months,3.38～4.36 μg/L at 12 months;no case recurred after treatment,the rate of which was significantly lower than the short-term group.Conclusion Short-term and long-term treatment of tacrolimus can relieve IMN evidently;low concentration of tacrolimus in the long-term group can alleviate the state of illness persistently with low recurrence rate.