Browsing by Author "Nesic, Vidosava (6701399962)"

Background/Aims: Glucocorticoids and classic immunosuppressive drugs can improve disease activity in primary glomerulonephritis (GN). However, these drugs have serious toxicity and patients frequently experience inadequate response or relapse, so there is a need for alternative agents. This multicenter uncontrolled study analyzed the efficacy and safety of mycophenolate mofetil (MMF) in high-risk patients with primary GN. Methods: A total of 51 patients with biopsy-proven membranous (n = 12), membranoproliferative (n = 15), mesangioproliferative (n = 10), focal segmental glomerulosclerosis (n = 13) and minimal change disease (n = 1) received MMF with low-dose corticosteroids for 1 year. The primary outcome included the number of patients with complete/partial remission. Results: Proteinuria significantly decreased, from its median value of 4.9 g/day (IQR 2.9-8.4) to 1.28 g/day (IQR 0.5-2.9), p < 0.001. The urine protein/creatinine ratio significantly improved, from a median of 3.72 (IQR 2.13-6.48) to 0.84 (IQR 0.42-2.01), p < 0.001. The mean area under the curve for proteinuria significantly decreased, from 4.99 ± 3.46 to 2.16 ± 2.46, between the first (visits 1-2) and last (vists 4-5) treatment periods (p < 0.001). The change was similar for every type of GN, without difference between groups. eGFR slightly increased (62.1 ± 31.8 to 65.3 ± 31.8 ml/min, p = n.s.) and ESR, total proteins, albumins, total- and HDL-cholesterol parameters improved significantly. Systolic, diastolic and mean blood pressure decreased (p < 0.02 for systolic blood pressure). The age of patients was the only independent predictor of complete or partial remission. Conclusion: MMF proved to be efficient in 70% of high-risk patients with primary GN, who reached either complete or partial remission without safety concern after 12 months of treatment. Favorable effects of MMF therapy have to be confirmed in the long term and particularly after discontinuation of the drug. © 2009 S. Karger AG, Basel.

Background. There is not enough epidemiologic data of biopsy proven renal diseases. This is the first report of clinicopathologic correlations over a period of 20 years from central Balkan country-Serbia. Methods. A retrospective review of reports of 2 362 native renal biopsies performed on patients at the leading nephrology unit in Serbia from 1987 to 2006 was undertaken. Patients were divided in two groups according to age: younger (<60 years old) and older (≥60 years old). Results. The annual incidence of renal biopsies increased from 3.9 p.m.p./year in 1987 to 12.5 p.m.p/year in 2006. The most common clinical syndrome as an indication for renal biopsy was nephrotic syndrome (NS) (53.6%). Membranous nephropathy was the most frequent cause of NS (21.6%). Primary glomerulonephritis (PGN) accounted for about two thirds of all performed biopsies. Non-IgA mesangioproliferative GN was the most frequent primary GN accounting for almost 25% of all PGN in our whole population, while the prevalence of IgA nephropathy was only 12%. Lupus nephritis was the most frequent secondary glomerulonephritis (75.6%). Conclusions. This report represents epidemiological overview on biopsy proven renal disease coming from one specific Balkan country, which was under economic sanctions for almost half the studied period. We are hoping that this register will be the basis for developing not only a national register but also a register that will encompass all Balkan countries. © The Author [2008]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.