Immunosuppressive Agents in the Treatment of Membranoproliferative Glomerulonephritis

Abstract

INTRODUCTION: Treatment of membranoproliferative glomerulonephritis (MPGN) is often unrewarding with approximately 60% of patients progressing to end-stage renal failure within 10 years. In our study, we compared the efficacy of CS alone versus low dose CS + another immunosuppressive agent retrospectively.

MATERIAL and METHODS: Twenty-nine patients (17 male) with MPGN were retrospectively grouped according to treatment protocols with CS (methylprednisolone 1mg/kg) (group 1, n=14); low dose CS + another immunosuppressive agent (group 2, n=15) [CS+MMF (n=6), CS+AZA (n=3), CS + CYC (n=6)]. Patients in all groups also received renin-angiotensin system (RAS) inhibitors.

RESULTS: All patients received treatment for 12 months. Remission occurred in 12 patients (85.7%) (9 complete and 3 partial) in group 1 and 10 patients (66.6%) (7 complete and 3 partial) in group 2 (p=0.316). No patients required dialysis within the one year of follow up complications. At one year of treatment the baseline proteinuria levels of patients in group 1 (5.83+2.91 g/day) and group 2 (5.37+4.05 g/day) significantly decreased to 0.21+0.42 g/day (p=0.005) and 1.92+3.31 g/day (p=0.037), respectively. In the first year of treatment mean glomerular filtration rate (GFR) values of patients in group 1 (105+40 mL/min) was significantly higher than the group 2 (66+23 mL/min) (p=0.005).

CONCLUSION: There is no significant extra benefit in treating adult MPGN patients with combination therapy including low dose CS plus various immunosuppressive agents.