title: Clinical features and treatment outcome of idiopathic membranous nephropathy in Chinese patients.
abstract: We retrospectively studied the clinical course and treatment outcome of idiopathic membranous nephropathy (IMN) amongst 38 Chinese patients (25 male, 13 female, age 51.6 +/- 14.6 years, follow-up duration 58.2 +/- 51.1 months) who presented over a 10-year review period. Eight never received any form of specific treatment (group I), seven received oral corticosteroid alone for 6-9 months (group II), 17 were given corticosteroid plus cyclophosphamide for 6-12 months (group III), and six were treated with methylprednisolone alternating with chlorambucil every other month for 6 months (group IV). No untoward effect from drugs sufficient to alter the dosage used was recorded. After 6 months of treatment, over 50% of patients went into remission: a significant reduction in proteinuria (p = 0.01, 0.01, 0.02) with a corresponding rise in serum albumin levels (p = 0.01, 0.01, 0.04) was observed in groups II, III, and IV, respectively, but not in group I. During follow-up, one patient in each of groups I, III, IV, and two of group II developed renal function deterioration, which correlated with an abnormal presenting serum creatinine. In six group I and eight group III patients who have been followed for at least 5 years, there was progressive reduction in proteinuria in group III (p < 0.05), but not in group I: serum creatinine has remained unchanged in both groups. IMN runs a benign course in Chinese patients in Hong Kong, with 2.6% of patients going into end-stage renal failure during the study period. Contrary to reports in Caucasians, there is similar treatment response to steroid alone or a combination of steroid and cytotoxic agents.
authors.affiliation: University Department of Medicine, Queen Mary Hospital, Hong Kong.
authors.forename: S
authors.initials: S
authors.lastname: Tang
authors.forename: T M
authors.initials: TM
authors.lastname: Chan
authors.forename: I K
authors.initials: IK
authors.lastname: Cheng
authors.forename: K N
authors.initials: KN
authors.lastname: Lai
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D002699:Chlorambucil / Q000627:therapeutic use; D003404:Creatinine / Q000097:blood; D003520:Cyclophosphamide / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D015433:Glomerulonephritis, Membranous / Q000188:drug therapy / Q000208:ethnology / Q000378:metabolism*; D005938:Glucocorticoids / Q000627:therapeutic use; D006723:Hong Kong / Q000208:ethnology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011239:Prednisolone / Q000627:therapeutic use; D011507:Proteinuria / Q000378:metabolism; D012189:Retrospective Studies; D012709:Serum Albumin / Q000032:analysis
chemical_list: D000959:Antihypertensive Agents; D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D012709:Serum Albumin; D002699:Chlorambucil; D003520:Cyclophosphamide; D011239:Prednisolone; D003404:Creatinine