A 10-year follow-up of idiopathic membranous nephropathy patients on steroids and cyclophosphamide: a case series

Figures & data

Table 1. Baseline characteristics of the patients.

Characteristic	Result
Number of patients	58
Age (mean) (years)	38.1
Age: range (years)	22 to 63
Male: female	40: 18
Duration of symptoms of nephrotic  symptoms prior to presentation (months)	10.7 ± 1.0*
Hypertension	6 (10.34%)
Serum creatinine in µmol/L (mg/dL)	108.7 ± 18.5 (1.2 ± 0.2)
Blood urea nitrogen in mmol/L (mg/dL)	17.8 ± 4.6 (6.3 ± 2.7)
Hemoglobin in g/L (g/dL)	129 ± 15 (12.9 ± 1.5)
Total serum proteins in g/L (g/dL)	48 ± 8 (4.8 ± 0.8)
Serum albumin in g/L (g/dL)	24 ± 3 (2.4 ± 0.3)
Serum cholesterol mmol/L (mg/dL)	8.5 ± 2.8 (329.1 ± 111.5)
24-hour urine protein (g/day)	6.1 ± 0.0.9
Mean number of glomeruli on renal biopsy	14.8 ± 7.9
Percentage of patients with 30% of glomeruli  sclerosed on renal biopsy	12.0
Percentage of patients with interstitial fibrosis  and tubular atrophy on renal biopsy	15.5
eGFR (mL/min/1.73 m^2)**	59.4 ± 21.8

Notes: *Based on history.

**Calculated using 6-variable MDRD formula.

Table 2. Progression in patients.

Number of patients (%)	9 Months	18 Months	36 Months	60 Months	96 Months	120 Months
Remission (CR + PR)	45 (77.5%)	43 (74.1%)	45 (77.5%)	42 (72.4%)	38 (65.5%)	34 (58.6%)
Complete remission	18 (31.0%)	18 (31.0%)	18 (31.0%)	16 (27.5%)	16 (27.5%)	16 (27.5%)
Partial remission	27 (46.5%)	25 (43.1%)	27 (46.5%)	24 (41.3%)	22 (37.9%)	18 (31.0%)
Persistent nephrotic syndrome or relapse*	13 (22.4%)	14 (24.1%)	10 (17.2%)	12 (20.6%)	14 (24.1%)	11 (18.9%)
Doubling of serum creatinine*	–	1 (1.7%)	3 (5.1%)	4 (6.8%)	5 (8.6%)	7 (12.0%)
ESRD	–	–	–	–	1 (1.7%)	6 (10.3%)
Death	–	–	–	–	–	–

Note: *Patients whose serum creatinine had doubled were not considered in the category of persistent nephrotic syndrome.

Table 3. Complications of therapy.

Complications
Psychosis	One patient each
Gastric intolerance to- cyclophosphamide
Acute pancreatitis
Myocardial infarction
Herpes zoster	2 Each
Bone marrow suppression
Pulmonary tuberculosis	9
Impaired glucose tolerance	5
Drug reaction	3
Total	25/58 (43.10%)

Table 4. Previous studies.

Reference	Number of patients	Initial remission rates	At 10-year follow-up
2, 3	42	30 (71.4%) at 2 years	92% Without developing ESRD
5	47	34 (72.3%) at 1 year	89% Dialysis free survival