Results of a controlled drug trial in membranoproliferative glomerulonephritis

Results of a controlled drug trial in membranoproliferative glomerulonephritis. A prospective randomized drug trial was carried out on 59 patients with confirmed membranoproliferative glomerulonephritis (MPGN). The treatment group (27 patients) received cyclophosphamide, Coumadin, and dipyridamole f...

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Published in:Kidney international 1985-02, Vol.27 (2), p.436-441
Main Authors: Cattran, Daniel C., Cardella, Carl J., Roscoe, Janet M., Charron, Richard C., Rance, Phillip C., Ritchie, Susan M., Corey, Paul N.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Age Factors
Biological and medical sciences
Child
Clinical Trials as Topic
Creatinine
Cyclophosphamide - administration & dosage
Cyclophosphamide - therapeutic use
Dipyridamole - administration & dosage
Dipyridamole - therapeutic use
Drug Therapy, Combination
Female
Glomerulonephritis - drug therapy
Humans
Kidney Function Tests
Male
Medical sciences
Middle Aged
Pharmacology. Drug treatments
Prospective Studies
Random Allocation
Time Factors
Urinary system
Warfarin - administration & dosage
Warfarin - therapeutic use
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Summary:Results of a controlled drug trial in membranoproliferative glomerulonephritis. A prospective randomized drug trial was carried out on 59 patients with confirmed membranoproliferative glomerulonephritis (MPGN). The treatment group (27 patients) received cyclophosphamide, Coumadin, and dipyridamole for 18 months, and the control group (32 patients) received no specific therapy. Complications of the renal disease such as hypertension and fluid retention were treated similarly in both groups. Entrance criteria included confirmed renal pathology demonstrating either types I or II MPGN, a corrected creatinine clearance (CCr) of less than 80 ml/min/1.73 m2, and/or proteinuria greater than 2 g/day. Actuarial survival was not different between the treatment and the control groups in either MPGN type and was 85% in type I and 90% in type II at 2 years. The change in renal function, as measured by both the slope of CCr and the plasma creatinine reciprocal (1/Cr) at 6, 12, and 18 months was not significantly different between treatment and control groups in either types I or II when tested by both parametric and nonparametric analysis. The age, sex, and initial level of CCr did not influence the rate of decline. Control and treatment group proteinuria was not different at any time point in either types I or II MPGN. The small numbers of type II MPGN cases do not give sufficient power to allow conclusions regarding this therapy in type II. We can conclude that this treatment is ineffective in altering the natural history of type I MPGN. Résultats d'un essai médicamenteux contrôlé dans la glomérulonéphrite membrano-proliférative. Un essai médicamenteux prospectif randomisé a été entrepris chez 59 malades atteints de glomérulonéphrite membrano-proliférative confirmée (MPGN). Le groupe traité (27 malades) a recu de la cyclophosphamide, de la coumadine et du dipyridamole pendant 18 mois, et le groupe contrôle (32 malades) n'a pas recu de traitement spécifique. Les complications de la néphropathie telles que l'hypertension et al rétention liquidinne ont été traitées de facon identique dans les deux groupes. Les critères d'inclusion comprenaient une histologiérénale confirmée démontrant une MPGN de type I ou de type II, une clearance de la créatinine corrigée (CCr) de moins de 80 ml/min/1,73 m2 et/ou une protéinurie de plus de 2 g/jour. La survie actuarielle ne différait pas entre les groupes traité et contrôle dans aucun des types de MPGN, et était de 85% dans le type I et
ISSN:0085-2538
1523-1755
DOI:10.1038/ki.1985.28