Membranous glomerulonephritis: treatment response and outcome in children

Title

Membranous glomerulonephritis: treatment response and outcome in children

Creator

Valentini R P; Mattoo T K; Kapur G; Imam A

Publisher

Pediatric Nephrology

Date

2009
2009-02

Description

The aim of this study was to characterize clinical features, treatment response, and outcome of idiopathic membranous glomerulonephritis (MGN) in a single-center cohort of children. A retrospective review of biopsy-proven idiopathic MGN in 12 children (mean age 11.9 years) was undertaken. Presentation was nephrotic syndrome (NS) (75%), hematuria/proteinuria (17%), and asymptomatic proteinuria (8%). Ten patients (83%) with NS and nephrotic range proteinuria (NRP) were treated with prednisone, and two patients with non-NRP were not treated with immunosuppressive medications. Steroid response in the treated patients was complete (10%), partial (40%), and absent (50%), respectively. Oral cyclophosphamide was used in seven patients of whom five were steroid resistant, one was steroid dependent, and one was partially responsive. At the mean follow up of 27 months, outcome parameters included an estimated glomerular filtration rate of 128 cc/min per 1.73 m(2), albumin of 4.2 gm/dL, and a urine protein/creatinine ratio of 0.87 [median 0.16 (range 0.02-6.52)]. Remission was complete in 75% of the patients and partial in 17%. One patient (8%) with chronic kidney disease (stage 2) was unresponsive to therapy. Complete remission was significantly associated with the absence of chronic histological changes (p=0.03). In conclusion, children with NS and/or NRP associated with MGN appear to have a good prognosis when treated with a combination of corticosteroids and cyclophosphamide.

Subject

childhood; chlorambucil; clinical course; cyclophosphamide; cyclophosphamide; glomerular-filtration-rate; glomerulonephropathy; glomerulosclerosis; Membranous; Membranous glomerulonephritis; methylprednisolone; nephropathy; nephrotic; Nephrotic syndrome; Pediatrics; syndrome; systemic lupus erythematosus; Urology & Nephrology

Format

Journal Article

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Rights

Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).

Pages

301-308

Issue

2

Volume

24

Citation

Valentini R P; Mattoo T K; Kapur G; Imam A, “Membranous glomerulonephritis: treatment response and outcome in children,” NEOMED Bibliography Database, accessed December 1, 2021, https://neomed.omeka.net/items/show/7383.

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