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Stepwise Treatment Using Corticosteroids Alone and in Combination with Cyclosporine in Korean Patients with Idiopathic Membranous Nephropathy

DC FieldValueLanguage
dc.contributor.author박정탁-
dc.contributor.author오형중-
dc.contributor.author유태현-
dc.contributor.author이미정-
dc.contributor.author최규헌-
dc.contributor.author한승혁-
dc.contributor.author한재현-
dc.contributor.author강신욱-
dc.contributor.author구향모-
dc.contributor.author김형래-
dc.contributor.author도화미-
dc.date.accessioned2014-12-18T08:55:17Z-
dc.date.available2014-12-18T08:55:17Z-
dc.date.issued2013-
dc.identifier.issn0513-5796-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/87197-
dc.description.abstractPURPOSE: We undertook an observational study to investigate the effects of immunosuppressive treatment on proteinuria and renal function in 179 Korean idiopathic membranous nephropathy patients with nephrotic syndrome. MATERIALS AND METHODS: The primary outcome was regarded as the first appearance of remission and the secondary outcomes as a decline in estimated glomerular filtration rate (eGFR) >50% or initiation of dialysis, and all-cause mortality. Seventy-two (40.2%) and 50 (27.9%) patients were treated with corticosteroids alone (C) and corticosteroids plus cyclosporine (C+C), respectively, whereas 57 (31.8%) did not receive immunosuppressants (NTx). Cyclosporine was added if there was no reduction in proteinuria of >50% from baseline by corticosteroids alone within 3 months. RESULTS: There were no differences in baseline renal function and the amount of proteinuria among the three groups. Overall, complete remission (CR) was achieved in 88 (72.1%) patients by immunosuppressants. In a multivariate analysis adjusted for covariates associated with adverse renal outcome, the probability of reaching CR was significantly higher in the C [hazard ratio (HR), 4.09; p<0.001] and C+C groups (HR, 2.57; p=0.003) than in the NTx group. Kaplan-Meier analysis revealed that 5-year CR rates of C, C+C, and NTx groups were 88.5%, 86.2%, and 56.7% (p<0.001). Ten-year event-free rates for the secondary endpoints in these three groups were 91.7%, 79.9%, and 57.2% (p=0.01). CONCLUSION: Immunosuppressive treatment was effective in inducing remission and preserving renal function in these patients. Therefore, stepwise treatment using corticosteroids alone and in combination with cyclosporine is warranted in these patients.-
dc.description.statementOfResponsibilityopen-
dc.formatapplication/pdf-
dc.relation.isPartOfYONSEI MEDICAL JOURNAL-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/2.0/kr/-
dc.subject.MESHAdrenal Cortex Hormones/adverse effects-
dc.subject.MESHAdrenal Cortex Hormones/therapeutic use*-
dc.subject.MESHAdult-
dc.subject.MESHAged-
dc.subject.MESHCyclosporine/adverse effects-
dc.subject.MESHCyclosporine/therapeutic use*-
dc.subject.MESHDrug Administration Schedule-
dc.subject.MESHFemale-
dc.subject.MESHGlomerular Filtration Rate/drug effects-
dc.subject.MESHGlomerulonephritis, Membranous/drug therapy*-
dc.subject.MESHGlomerulonephritis, Membranous/mortality-
dc.subject.MESHHumans-
dc.subject.MESHImmunosuppressive Agents/adverse effects-
dc.subject.MESHImmunosuppressive Agents/therapeutic use*-
dc.subject.MESHKaplan-Meier Estimate-
dc.subject.MESHKidney/drug effects-
dc.subject.MESHKidney/physiology-
dc.subject.MESHMale-
dc.subject.MESHMiddle Aged-
dc.subject.MESHProteinuria/chemically induced-
dc.subject.MESHTreatment Outcome-
dc.titleStepwise Treatment Using Corticosteroids Alone and in Combination with Cyclosporine in Korean Patients with Idiopathic Membranous Nephropathy-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Internal Medicine (내과학)-
dc.contributor.googleauthorDong Ho Shin-
dc.contributor.googleauthorMi Jung Lee-
dc.contributor.googleauthorHyung Jung Oh-
dc.contributor.googleauthorHyang Mo Koo-
dc.contributor.googleauthorFa Mee Doh-
dc.contributor.googleauthorHyoung Rae Kim-
dc.contributor.googleauthorJae Hyun Han-
dc.contributor.googleauthorJung Tak Park-
dc.contributor.googleauthorSeung Hyeok Han-
dc.contributor.googleauthorKyu Hun Choi-
dc.contributor.googleauthorTae-Hyun Yoo-
dc.contributor.googleauthorShin-Wook Kang-
dc.identifier.doi10.3349/ymj.2013.54.4.973-
dc.admin.authorfalse-
dc.admin.mappingfalse-
dc.contributor.localIdA01654-
dc.contributor.localIdA02097-
dc.contributor.localIdA02417-
dc.contributor.localIdA02526-
dc.contributor.localIdA04043-
dc.contributor.localIdA04304-
dc.contributor.localIdA04320-
dc.contributor.localIdA00053-
dc.contributor.localIdA00203-
dc.contributor.localIdA01147-
dc.contributor.localIdA01315-
dc.contributor.localIdA02773-
dc.relation.journalcodeJ02813-
dc.identifier.eissn1976-2437-
dc.identifier.pmid23709434-
dc.subject.keywordCorticosteroids-
dc.subject.keywordcyclosporine-
dc.subject.keywordidiopathic membranous nephropathy-
dc.subject.keywordnephrotic syndrome-
dc.subject.keywordremission-
dc.contributor.alternativeNamePark, Jung Tak-
dc.contributor.alternativeNameShin, Dong Ho-
dc.contributor.alternativeNameOh, Hyung Jung-
dc.contributor.alternativeNameYoo, Tae Hyun-
dc.contributor.alternativeNameLee, Mi Jung-
dc.contributor.alternativeNameChoi, Kyu Hun-
dc.contributor.alternativeNameHan, Seung Hyeok-
dc.contributor.alternativeNameHan, Jae Hyun-
dc.contributor.alternativeNameKang, Shin Wook-
dc.contributor.alternativeNameKoo, Hyang Mo-
dc.contributor.alternativeNameKim, Hyoung Rae-
dc.contributor.alternativeNameDoh, Fa Mee-
dc.contributor.affiliatedAuthorPark, Jung Tak-
dc.contributor.affiliatedAuthorShin, Dong Ho-
dc.contributor.affiliatedAuthorOh, Hyung Jung-
dc.contributor.affiliatedAuthorYoo, Tae Hyun-
dc.contributor.affiliatedAuthorChoi, Kyu Hun-
dc.contributor.affiliatedAuthorHan, Seung Hyeok-
dc.contributor.affiliatedAuthorHan, Jae Hyun-
dc.contributor.affiliatedAuthorKang, Shin Wook-
dc.contributor.affiliatedAuthorKoo, Hyang Mo-
dc.contributor.affiliatedAuthorKim, Hyoung Rae-
dc.contributor.affiliatedAuthorDoh, Fa Mee-
dc.contributor.affiliatedAuthorLee, Mi Jung-
dc.rights.accessRightsfree-
dc.citation.volume54-
dc.citation.number4-
dc.citation.startPage973-
dc.citation.endPage982-
dc.identifier.bibliographicCitationYONSEI MEDICAL JOURNAL, Vol.54(4) : 973-982, 2013-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers

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