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Membranous glomerulonephritis: treatment response and outcome in children
- Source :
- Pediatric Nephrology. 24:301-308
- Publication Year :
- 2009
- Publisher :
- Springer Science and Business Media LLC, 2009.
-
Abstract
- The aim of this study was to characterize clinical features, treatment response, and outcome of idiopathic membranous glomerulonephritis (MGN) in a single-center cohort of children. A retrospective review of biopsy-proven idiopathic MGN in 12 children (mean age 11.9 years) was undertaken. Presentation was nephrotic syndrome (NS) (75%), hematuria/proteinuria (17%), and asymptomatic proteinuria (8%). Ten patients (83%) with NS and nephrotic range proteinuria (NRP) were treated with prednisone, and two patients with non-NRP were not treated with immunosuppressive medications. Steroid response in the treated patients was complete (10%), partial (40%), and absent (50%), respectively. Oral cyclophosphamide was used in seven patients of whom five were steroid resistant, one was steroid dependent, and one was partially responsive. At the mean follow up of 27 months, outcome parameters included an estimated glomerular filtration rate of 128 cc/min per 1.73 m(2), albumin of 4.2 gm/dL, and a urine protein/creatinine ratio of 0.87 [median 0.16 (range 0.02-6.52)]. Remission was complete in 75% of the patients and partial in 17%. One patient (8%) with chronic kidney disease (stage 2) was unresponsive to therapy. Complete remission was significantly associated with the absence of chronic histological changes (p = 0.03). In conclusion, children with NS and/or NRP associated with MGN appear to have a good prognosis when treated with a combination of corticosteroids and cyclophosphamide.
- Subjects :
- Male
Nephrology
medicine.medical_specialty
Nephrotic Syndrome
Adolescent
Biopsy
Renal function
Idiopathic membranous glomerulonephritis
Glomerulonephritis, Membranous
Gastroenterology
Cohort Studies
Prednisone
Internal medicine
medicine
Humans
Child
Cyclophosphamide
Retrospective Studies
Proteinuria
business.industry
Remission Induction
Glomerulonephritis
medicine.disease
Treatment Outcome
Endocrinology
Child, Preschool
Pediatrics, Perinatology and Child Health
Female
medicine.symptom
business
Nephrotic syndrome
Immunosuppressive Agents
medicine.drug
Kidney disease
Subjects
Details
- ISSN :
- 1432198X and 0931041X
- Volume :
- 24
- Database :
- OpenAIRE
- Journal :
- Pediatric Nephrology
- Accession number :
- edsair.doi.dedup.....b839ced33b733b027b82161e2280d167