Cyclosporine is not inferior to cyclophosphamide in the treatment of idiopathic membranous glomerulonephritis: single centre experience

Objectives: Membranous glomerulonephritis remains the most common cause of adult-onset nephrotic syndrome and its management is still controversial. In our study we aimed to compare the response rates of cyclophosphamide and cyclosporine treatment during a 12-month treatment period. This study was a retrospective trial at the Nephrology Department of Numune Research and Education Hospital, Turkey. Methods: Fourty-seven patients with well-preserved renal function and we have analyzed treatment response with cyclosporine and prednisone or cyclophosphamide and prednisone. All patients were followed for an average of 12 months, and the partial and complete remission rates were assessed at 12th month with serum albumin, serum creatinin, glomerular filtration rate and 24-hour urine protein levels. Results: Fourty-seven patients (33 male and 14 female) with a mean age of 37.68±13.18 years were included in the study. 17 (36.2%) patients were in the cyclosporine group and 30 (63.8%) were in the cyclophosphamide group. Baseline characteristics of the groups were similar. Seventy-six percent of the cyclophosphamide group versus 82.4% of the cyclosporine group had a partial or complete remission of proteinuria at the end of 12 months (P=0.89). Serum albumin levels increased and proteinuria were significantly reduced in all groups (P=0.001). Conclusion: This study suggests that cyclosporine-based regimens are not inferior than cyclophosphamide in the treatment of membranous glomerulonephritis