J Assoc Physicians India. 2022 Mar;70(3):11-12.
ABSTRACT
INTRODUCTION: Idiopathic Membranous nephropathy (IMN) is one of the most common causes of adult onset nephrotic syndrome worldwide. About 50% will slowly progress to renal failure if untreated.
METHODS: We did a retrospective study in patients with Idiopathic membranous nephropathy who were on follow-up between 2016-2018 at Madras medical college, Chennai. Clinical records, investigations, treatment and treatment response were analyzed. Risk stratification was done according to urine protein estimation, Modified Ponticelli regimen was administered in patients with high risk of renal failure and those with complications. They were followed up 6-12 months.
RESULTS: Among 61 patients with IMN, 37 were treated with Modified Ponticelli regimen after 6months of supportive treatment. Spontaneous remission was 14%, after mean follow up of 3.14 yrs total remission was 64.86 %( CR 43.24%; PR-21.62%) and 35.14% had no remission. Three patients progressed to CKD. Tacrolimus was initiated in non responders to IST. Analysis between IST responders and non responders shows those who presented with lesser proteinuria had statistically better outcome.
CONCLUSION: This retrospective study of IMN showed a reasonably better outcome. Seventeen per cent of patients had spontaneous remission and 64.86% achieved remission with Modified Ponticelli regimen.
PMID:35438279
