Original Article Induction and long-term treatment with cyclosporine in membranous nephropathy with the nephrotic syndrome

Background. Cyclosporine A (CyA) has been shown to be effective in membranous nephropathy (MN). However, the optimal dose and the duration of treatment remain controversial issues. We evaluated the efficacy of low-dose CyA alone or combined with corticosteroids as induction and long-term treatment for nephrotic patients with MN. Methods. In the first part of the study, 51 nephrotic patients with MN were treated either with CyA and prednisolone (n 31) or CyA alone (n 20) for 12 months. Patients who responded with complete remis-sion (CR) or partial remission (PR) were placed on long-term treatment with lower doses of CyA and prednisolone or CyA alone. The mean follow-up of the second part of the study was 26 16 months and 18 7 months, respectively. Results. After 12 months of treatment, 26 patients in the combination group and 17 patients in the mono-therapy group had a CR or PR of proteinuria (PNS). Renal function was unchanged in the two groups. During long-term treatment relapses were more frequent in the monotherapy group (47 vs 15%, P< 0.05). Daily CyA dose was higher in non-relapsers in both groups (combination 1.4 0.5 v