Efficacy of tacrolimus combined with glucocorticoid in the treatment of idiopathic membranous nephropathy and its influence on serum indicators and renal function
Objective To explore the efficacy of tacrolimus combined with glucocorticoid in the treatment of idiopathic membranous nephropathy(IMN)and its influence on serum indicators and renal function.Methods 86 patients with IMN were randomly divided into a control group and an observation group,with 43 cases in each group.The control group was treated with glucocorticoid alone,and the observation group was treated with tacrolimus combined with glucocorticoid.Both groups were compared in terms of clinical efficacy,renal function indicators[24 h urinary protein quantification(UP),serum creatinine(Scr),albumin(ALB),estimated glomerular filtration rate(eGFR)],inflammatory factors and antibodies[C-reactive protein(CRP),M-type phospholipase A2 receptor(PLA2R)antibody]and the occurrence of adverse reactions.Results The total effective rates of the observation group were 72.09%and 81.40%after 3 and 6 months of treatment,which were significantly higher than 34.88%and 41.86%of the control group(P<0.05).After 1,3 and 6 months of treatment,the 24 h UP and Scr of the observation group were significantly lower than those of the control group,and the ALB and eGFR were significantly higher than those of the control group(P<0.05).After 6 months of treatment,the PLA2R antibody and CRP levels in the observation group were(11.03±2.01)RU/ml and(2.11±0.68)mg/L,which were lower than(14.08±3.02)RU/ml and(5.27±1.15)mg/L in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the observation group and the control group(P>0.05).Conclusion Tacrolimus combined with glucocorticoid has a significant effect in the treatment of IMN,which can effectively improve renal function,reduce inflammation and reduce PLA2R antibody level,and has good efficacy and safety.
Idiopathic membranous nephropathyTacrolimusGlucocorticoidSerum indicatorsRenal function
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