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The Effect of Rituximab assisted Prednisone and Cyclophosphamide on the Treatment of Idiopathic Membranous Nephropathy and Its Influence on Serum Nephrin and BAFF Levels

The Effect of Rituximab assisted Prednisone and Cyclophosphamide on the Treatment of Idiopathic Membranous Nephropathy and Its Influence on Serum Nephrin and BAFF Levels

Yan Jiang1,2, Xia Tao3,4 and Hongxia Chen5,6*

1Hemodialysis Room of Nephrology, The Fourth People’s Hospital of Jinan, Jinan, 250031, China
2Hemodialysis Room of Nephrology, The Third Affiliated Hospital of Shandong First Medical University, Jinan, 250031, China
3Endoscopy Center, The Fourth People’s Hospital of Jinan, Jinan, 250031, China
4Endoscopy Center, The Third Affiliated Hospital of Shandong First Medical University, Jinan, 250031, China
5Nephrology, The Fourth People’s Hospital of Jinan, Jinan, 250031, China
6Nephrology, The Third Affiliated Hospital of Shandong First Medical University, Jinan, 250031, China
 
* Corresponding author: chxchxl@163.com

ABSTRACT

The aim of this study was to explore the effect of rituximab-assisted prednisone and cyclophosphamide on the treatment of idiopathic membranous nephropathy (IMN) and its influence on serum levels of nephrin and B-cell activation factor belonging to the TNF family (BAFF). For this purpose, a prospective randomized controlled study method was designed for this study. 92 patients with IMN in our hospital from December 2015 to December 2017 were divided into study group (n=46) and control group (n=46) based on a computer-generated random number table. On the basis of conventional treatment, the control group was given prednisone and cyclophosphamide treatment, and the study group was given rituximab-assisted prednisone and cyclophosphamide treatment, both of which were treated for 6 months. The efficacy, adverse reactions, and recurrence rates of 1 and 2 years after treatment, clinical symptom scores and renal function indices such as urine protein quantification (Upro), blood creatinine (Scr), urea nitrogen (BUN)), serum albumin (ALB), nephrin, and BAFF levels before treatment, 3 months after treatment, and 6 months after treatment were compared between the 2 groups. Results showed that after treatment, the total effective rate of the study group was 93.48% higher than that of the control group 76.09% (P<0.05). The clinical symptom scores of the two groups were lower than those before treatment, and the score of study group was lower than that of the control group after 3 and 6 months of treatment (P<0.05). The 24h levels of Upro, serum Scr, BUN, and BAFF after 3 months and 6 months of treatment in the two groups were lower than those before treatment. The levels of the study group were lower than those of the control group. The serum ALB and nephrin levels were higher than those before treatment. The levels of the study group were higher than those of the control group (P<0.05). The two-year recurrence rate of the study group was 9.09% lower than that of the control group 25.00% (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). To conclude, the application of rituximab-assisted prednisone and cyclophosphamide in the treatment of IMN can improve serum nephrin and BAFF levels, reduce clinical symptoms, improve renal function and curative effect, and reduce recurrence rate, and is safe.

 

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Pakistan Journal of Zoology

June

Vol. 54, Iss. 3, Pages 1001-1500

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