Immunosuppression and outcome in idiopathic membranous nephropathy.
From 1986 to 1996, 53 patients with idiopathic membranous nephropathy (IMN) presented to the Glasgow Royal Infirmary renal unit: 19 (36%) were treated because of progressive disease. We compared outcomes of treated and untreated patients with 37 historical and untreated controls. Five- and 10-year survival rates off dialysis were 83.5 and 53.5%, respectively. At the end of a mean observation period of 5.9 years, 47% of patients were in remission, 13% had reached end-stage renal failure, 15% had died, 13% had persistent proteinuria but stable renal function, and 11% had declining renal function. These results are better than those in historical controls, with a reduction in the number of patients reaching ESRF (13% vs. 22%), a larger proportion of patients achieving remission (47% vs. 30%) and smaller numbers of patients with declining renal function (11% vs. 19%) at the end of a similar follow-up period. These data suggest that the use of immunosuppression in selected patients with IMN improves prognosis, although the results did not achieve statistical significance.
Stirling
C M
CM
Renal Unit, Glasgow Royal Infirmary, UK.
Simpson
K
K
Boulton-Jones
J M
JM
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D015433:Glomerulonephritis, Membranous / Q000150:complications / Q000628:therapy*; D006801:Humans; D007165:Immunosuppression Therapy; D007676:Kidney Failure, Chronic / Q000209:etiology; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D015996:Survival Rate; D016896:Treatment Outcome