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논문분류	춘계학술대회 초록집
제목	The prognosis of primary membranous nephropathy treated with calcineurin inhibitors vs. cyclophosphamide: a multi-center retrospective study
저자	Weiting He
출판정보	2024; 2024(1):
키워드
초록	Objectives: The prognosis of primary membranous nephropathy (PMN) treated with calcineurin inhibitors (CNIs) or cyclophosphamide (CTX) remains to be determined. Methods: The clinicopathological data of 872 PMN patients with a median follow up of 42 months were collected from three centers in China between 2003 and 2018. The prognosis of patients receiving CNIs versus CTX-based therapy were analyzed in the propensity-score matched (PSM) patients. Primary outcomes were a composite of a 50% decline in eGFR, progression to end-stage renal disease, or all-cause mortality. Dual immunohistochemical staining of CD31 and α-smooth muscle action were applied to detect pathological vascular lesions. Results: A total of 761 patients were included in the study. After PSM, CTX-based therapy exhibited a significantly better renal survival compared to CNIs-based therapy (median, 156 months vs. 108 months; hazard ratio [HR], 0.29; 95% confidence interval [CI]0.15 to 0.58; p<0.001). However, no significant difference in complete remission of proteinuria was found between 117 paired patients (HR, 1.25; 95% CI, 0.9 to 1.75; p = 0.19). Subgroup analyses showed that CTX-based therapy was superior to CNIs-based therapy among patients with hyalinosis damage (HR, 0.16; 95% CI 0.05 to 0.51; p = 0.002; p for interaction = 0.356), arteriosclerosis (HR, 0.28; 95% CI 0.14 to 0.56; p < 0.001; p for interaction = 0.356), or hypertension (HR, 0.19; 95% CI 0.08 to 0.47; p < 0.001; p for interaction = 0.129). Conclusions: CTX-based therapy exhibited a significantly impoved renal survival compared to CNIs-based therapy in PMN patients.
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