View : 30 Download: 0

Treatment and clinical outcomes of elderly idiopathic membranous nephropathy: A multicenter cohort study in Korea

Title
Treatment and clinical outcomes of elderly idiopathic membranous nephropathy: A multicenter cohort study in Korea
Authors
Bae E.Lee S.W.Park S.Kim D.K.Lee H.Huh H.Chin H.J.Lee S.Ryu D.-R.Park J.I.Kim S.Park D.J.Kang S.-W.Kim Y.S.Oh Y.K.Kim Y.C.Lim C.S.Park J.T.Lee J.P.
Ewha Authors
류동열이신아
SCOPUS Author ID
류동열scopus; 이신아scopusscopus
Issue Date
2018
Journal Title
Archives of Gerontology and Geriatrics
ISSN
0167-4943JCR Link
Citation
Archives of Gerontology and Geriatrics vol. 76, pp. 175 - 181
Keywords
Angiotensin II receptor blocker or angiotensin-converting enzyme inhibitorElderlyMembranous nephropathy
Publisher
Elsevier Ireland Ltd
Indexed
SCI; SCIE; SCOPUS WOS scopus
Document Type
Article
Abstract
Idiopathic membranous nephropathy (MN) is the most common glomerulonephritis in elderly patients showing nephrotic syndrome. However, little is known about its treatment options and outcomes in elderly MN patients at long term follow-up. We retrospectively enrolled patients with biopsy-proven MN between April 1990 and December 2015 from eight tertiary hospitals in Korea. Among them, we excluded patients who had secondary causes of MN and subnephrotic-range proteinuria. We evaluated the presenting features and clinical outcomes and analyzed the all-cause mortality, renal outcomes, infection, and remission with respect to age. During the median follow-up at 77.2 months, 198 younger patients (<65 years) and 133 elderly patients (≥65 years) were enrolled. Age was an independent risk factor for all-cause mortality, renal outcome, and infection (for all P < 0.05) except remission. In elderly patients, there was no significant factor associated with mortality rate. The use of angiotensin-converting enzyme inhibitor (ACEI) or angiotensin II receptor blocker (ARB) was significantly associated with renal outcome and infection (renal outcome, hazard ration [HR] 0.06, 95% confidence intervals [CI] 0.01–0.36, P = 0.003; infection, HR 0.20, 95% CI 0.04–0.94, P = 0.041). Immunosuppressant therapy significantly increased renal outcome (P = 0.045) and infection (P = 0.029) compared with conservative therapy. In conclusion, old age is one of the clinically important predictors for MN patients. Among the treatment of elderly MN patients, only ACEI or ARB was associated with beneficial effects on renal outcome and infection. Elderly MN patients need a more tailored regimen considering their comorbidities and condition. © 2018
DOI
10.1016/j.archger.2018.03.002
Appears in Collections:
의과대학 > 의학과 > Journal papers
Files in This Item:
There are no files associated with this item.
Export
RIS (EndNote)
XLS (Excel)
XML


qrcode

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

BROWSE