Objective We intended to get a good understanding of the current role of alkylating agents in the treatment of idiopathic membranous nephropathy (IMN) with nephrotic syndrome (NS).
Methods We searched the Cochrane Library ( Issue 3, 2005), MEDLINE (1978 Jun., 2005) and CBM disc(1978-2005) to get the current best evidence of alkylating agents for treating IMN with NS and further critically appraised the available evidence.
Results Alkylating agents showed a significant beneficial effect on complete remission of proteinuria. The treatment of glucocorticoid with cyclophosphamide (MP+CTX) was one of the best managements among the various regimens suggested for IMN, but it was not clear about its long-term effect on renal survival rate. Given the current best evidence together with our clinical experience and the attitudes of the patient and family members, the treatment of (MP+CTX) was administered. There was a significant remission of proteinuria after 6 months follow-up.
Conclusions The treatment of (MP+CTX) can significantly improve the remission of proteinuria, however further observations on the long-term effect of alkylating agents on renal survival rate are required.
Citation: ZHANG Ling,WU Hongmei. Evidence-based Treatment of Alkylating Agents for Idiopathic Membranous Nephropathy with Nephrotic Syndrome. Chinese Journal of Evidence-Based Medicine, 2006, 06(7): 529-532. doi: Copy