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- Title
TREATMENT OF PROLIFERATIVE LUPUS NEPHRITIS WITH CYCLOPHOSPHAMIDE.
- Authors
Munteanu, Andreea; Caraba, A.; Romosan, I.
- Abstract
Lupus nephritis (LN) is one of the most severe and common manifestations of SLE, being a major cause of morbidity and death. Renal impairment plays a determinant role in the development of the disease, renal failure being one of the main death causes in SLE. The incidence of LN varies according to the diagnostic methods used. When diagnosis is established solely based on clinico-biological criteria, the incidence of LN ranges between 60 and 80%. On the other hand, diagnosis established on the basis of the histological exam of the kidney fragment obtained by renal needle biopsy shows that LN has an incidence ranging between 95 – 100%. The aim of the study is to underline the role of the histological exam in establishing the diagnosis of LN and the effectiveness of low-dose treatment with cyclophosphamide associated with metylprednisone versus the standard therapy. The study was conducted on thirty patients (all females) suffering with SLE with kidney impairment, admitted in the Timisoara Railways Hospital between 2007 and 2011. Renal needle biopsy was performed for all patients in order to establish an accurate diagnosis of LN. Proteinuria, haematuria and creatinine clearance were determined at the beginning of the study and after treatment. The group of patients was divided into two sub-groups which were treated with different doses of cyclophosphamide associated with metylprednisone (standard doses vs. low doses). After performind renal needle biopsy, only 18 patients remained in the study group, i.e., those with proliferative LN. The mean age was 37 years. There was a significant correction of the values of proteinuria and creatinine clearance after treatment, both in sub-group 1 (the NIH Protocol) and in sub-group 2 (the Euro-Lupus Protocol). The results obtained by using both types of protocols were statistically insignificant (p<0.01). The histological exam ascertains the positive disgnosis of lupus nephritis, assesses the class and stage of the disease, and offers prognostic information, thus guiding therapy.
- Subjects
LUPUS nephritis; TREATMENT of glomerulonephritis; CYCLOPHOSPHAMIDE; ANTIRHEUMATIC agents; IMMUNOSUPPRESSIVE agents; KIDNEY disease treatments; THERAPEUTICS
- Publication
Annals of the Romanian Society for Cell Biology, 2012, Vol 17, Issue 2, p153
- ISSN
2067-3019
- Publication type
Article