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Spontaneous remission of nephrotic syndrome in idiopathic membranous nephropathy

热2 qxm123 添加于 2010-4-16 16:58 | 2065 次阅读 | 0 个评论

作者
Polanco N, Gutierrez E, Covarsi A, Ariza F, Carreno A, Vigil A, Baltar J, Fernandez-Fresnedo G, Martin C, Pons S, Lorenzo D, Bernis C, Arrizabalaga P, Fernandez-Juarez G, Barrio V, Sierra M, Castellanos I, Espinosa M, Rivera F, Oliet A, Fernandez-Vega F, Praga M
摘要
Spontaneous remission is a well known characteristic of idiopathic membranous nephropathy, but contemporary studies describing predictors of remission and long-term outcomes are lacking. We conducted a retrospective, multicenter cohort study of 328 patients with nephrotic syndrome resulting from idiopathic membranous nephropathy that initially received conservative therapy. Spontaneous remission occurred in 104 (32%) patients: proteinuria progressively declined after diagnosis until remission of disease at 14.7 +/- 11.4 months. Although spontaneous remission was more frequent with lower levels of baseline proteinuria, it also frequently occurred in patients with massive proteinuria: 26% among those with baseline proteinuria 8 to 12 g/24 h and 22% among those with proteinuria >12 g/24 h. Baseline serum creatinine and proteinuria, treatment with angiotensin-converting enzyme inhibitors or angiotensin receptor antagonists, and a >50% decline of proteinuria from baseline during the first year of follow-up were significant independent predictors for spontaneous remission. Only six patients (5.7%) experienced a relapse of nephrotic syndrome. The incidence of death and ESRD were significantly lower among patients with spontaneous remission. In conclusion, spontaneous remission is common among patients with nephrotic syndrome resulting from membranous nephropathy and carries a favorable long-term outcome with a low incidence of relapse. A decrease in proteinuria >50% from baseline during the first year predicts spontaneous remission.
详细资料
- 文献种类:期刊
- 期刊名称: Journal of the American Society of Nephrology : JASN
- 期刊缩写: J Am Soc Nephrol
- 期卷页: 2010年第21卷第4期 697-704页
- 地址: Hospital 12 de Octubre, Madrid, Spain
- ISBN: 1046-6673
- 备注:PMID:20110379
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附件
Spontaneous remission of nephrotic syndrome in idiopathic membranous nephropathy

qxm123 的文献笔记订阅

自发缓解，这是众所周知的特发性膜性肾病的特点，但现代研究成果，描述缓解和长期预测结果缺乏。我们进行了回顾性，多中心的328例特发性膜性肾病肾病从最初接受保守治疗导致综合征患者队列研究。自发缓解发生在104（32％）患者：蛋白尿诊断后逐步下降，直到缓解病情在14.7+11.4个月。虽然自发缓解蛋白尿与基线水平较低更加频繁，但也经常发生在大量蛋白尿患者：在与基准蛋白尿者26％的患者8至12 g/24 h和蛋白尿者中有22％>12 g/24 h 。基处血清肌酐，尿蛋白，血管紧张素转化酶抑制剂或受体拮抗剂，并在第一年内有>50％的蛋白尿从基线下降的后续自发性缓解了显着的独立预测因子治疗。只有6例（5.7％）经历了肾病综合症复发。在自发缓解患者中的死亡和终末期肾病的发病率是较低的。总之，自发缓解是从常见的膜性肾病肾病综合征患者产生带有良好的长期的低复发率的结果。第一年内蛋白尿从基线下降>50％有自发缓解。

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