Idiopathic membranous nephropathy in the elderly

P. Passerini, G. Como, E. Vigano, P. Melis, C. Pozzi, P. Altieri, C. Ponticelli

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

In this retrospective non-randomized study we reviewed the outcome for 41 patients with membranous nephropathy older than 65 years at onset and followed for at least 1 year. Twelve of the patients never received any specific treatment (group A), 15 were treated with a 6-month course of methylprednisolone alternated to chlorambucil every other month (group B), and 14 received corticosteroids alone for 3-12 months (group C). At the end of a mean follow-up of 92 ± 61 months in group A, 53 ± 35 in group B, and 38 ± 25 in group C there were significantly more remissions of nephrotic syndrome in group B than in group A (P = 0.035) or in group C (P = 0.010). Moreover patients in group B spent a significantly longer period without nephrotic syndrome than patients in group A (P = 0.000) and C (P = 0.000). Three patients in group A and one in group B died. During the follow-up six patients of group A, two of group B, and five of group C developed renal function deterioration. In patients followed for at least 5 years the mean plasma creatinine increased from a basal of 112 ± 29 to 239 ± 287 μmol/l at the 5th year in group A and from 113 ± 14 to 124 ± 30 μmol/l in group B. The mean urine protein excretion remained unchanged in group A (basal 4.6 ± 2.3 versus 4.8 ± 5.7 g/day at 5 years) while it decreased in group B (from a basal of 6.8 ± 3.5 to 1.1 ± 0.4 g/day at 5 years). The natural course of membranous nephropathy in older patients is similar to that of patients of the second age. Corticosteroids alone do not modify the outcome. Corticosteroids alternated with chlorambucil seem to improve the chances of remission and to protect from renal dysfunction, but elderly patients are more exposed to the side-effects of this regimen. Thus this treatment should be limited to patients with severe nephrotic syndrome and/or incipient renal insufficiency, using some particular cautions.

Original languageEnglish
Pages (from-to)1321-1325
Number of pages5
JournalNephrology Dialysis Transplantation
Volume8
Issue number12
Publication statusPublished - 1993

Fingerprint

Membranous Glomerulonephritis
Nephrotic Syndrome
Chlorambucil
Adrenal Cortex Hormones
Kidney
Methylprednisolone
Renal Insufficiency
Creatinine
Outcome Assessment (Health Care)
Urine

Keywords

  • Alkylating agents
  • Corticosteroids
  • Glomerulonephritis
  • Immunosuppressive therapy
  • Membranous nephropathy
  • Renal disease in the elderly

ASJC Scopus subject areas

  • Nephrology
  • Transplantation

Cite this

Passerini, P., Como, G., Vigano, E., Melis, P., Pozzi, C., Altieri, P., & Ponticelli, C. (1993). Idiopathic membranous nephropathy in the elderly. Nephrology Dialysis Transplantation, 8(12), 1321-1325.

Idiopathic membranous nephropathy in the elderly. / Passerini, P.; Como, G.; Vigano, E.; Melis, P.; Pozzi, C.; Altieri, P.; Ponticelli, C.

In: Nephrology Dialysis Transplantation, Vol. 8, No. 12, 1993, p. 1321-1325.

Research output: Contribution to journalArticle

Passerini, P, Como, G, Vigano, E, Melis, P, Pozzi, C, Altieri, P & Ponticelli, C 1993, 'Idiopathic membranous nephropathy in the elderly', Nephrology Dialysis Transplantation, vol. 8, no. 12, pp. 1321-1325.
Passerini P, Como G, Vigano E, Melis P, Pozzi C, Altieri P et al. Idiopathic membranous nephropathy in the elderly. Nephrology Dialysis Transplantation. 1993;8(12):1321-1325.
Passerini, P. ; Como, G. ; Vigano, E. ; Melis, P. ; Pozzi, C. ; Altieri, P. ; Ponticelli, C. / Idiopathic membranous nephropathy in the elderly. In: Nephrology Dialysis Transplantation. 1993 ; Vol. 8, No. 12. pp. 1321-1325.
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