Complete remissioninducedbytacrolimusandlow-doseprednisolonein adult minimalchangenephroticsyndrome:Apilotstudy

• Published in: Kidney research and clinical practice pp. 112 - 117
• Main Authors: 김용철, 김성권, 주권욱, 진호준
• Format: Journal Article
• Language: English
• Published: 대한신장학회 01.06.2012
• Subjects: 내과학
• ISSN: 2211-9132; 2211-9140

Background: Few clinicaltrialshaveexaminedthereplacementofsteroidswith other immunosuppressivedrugsasaprimarytreatmentmodalityforminimal change disease(MCD)inadults.Westudiedtheefficacyoftacrolimustoinduce complete remission(CR)inadultswithMCD. Methods: We enrolled14adultswithMCDandnephrotic-rangeproteinuria.All patients weretreatedwithoraltacrolimus0.05mg/kgtwicedailyandpredniso-lone 0.5mg/kg/day.CRwasdefinedasaurineproteintocreatinineratioofo0.2 g protein/g creatinine(g/gcr).Theprimaryoutcomewascumulativepercentageof CR during16weeks. Results: The meanurineproteintocreatinineratioatenrollmentwas10.9g/gcr (range: 4.2–18.1g/gcr).Thetroughtacrolimuslevelwasmaintainedat5.9972.63 ng/mL.CRwasachievedby13/14(92.8%)patientswithin8weeks.The cumulative CRratewas7.7%(1/14),64.2%(9/14),71.3%(10/14),and92.9%(13/14)at 1week,2weeks,4weeks,and8weeks,respectively.Theoneremainingpatient achieved CRat20weeksaftertreatment,whowasfollowedupforafurther 4 weeks.ThemeantimetoachieveCRinthe14patientswas4.6475.11 (1–20)weeks. Threecasessufferedadverseeventsofabdominalpain,diarrhea,ornew-onset diabetesmellitus. Conclusion: Tacrolimusandlow-doseprednisolonetherapyinducedCRrapidly (71.3% by4weeksand100%by20weeks)andeffectivelyinadultpatientswithMCD. KCI Citation Count: 1