How do you manage a young female patient with membranous nephropathy and more than 11g/day proteinuria who not respond to steroid alone nor steroid+MMF therapy but had partial response to steroid and cyclosporine. (Proteinuria now 5g/day).

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How do you manage a young female patient with membranous nephropathy and more than 11g/day proteinuria who not respond to steroid alone nor steroid+MMF therapy but had partial response to steroid and cyclosporine. (Proteinuria now 5g/day).

A 26 year-old lady with nephrotic syndrome secondary to membranous nephropathy with normal baseline serum creatinine (S Cr between 0.86 – 1.1 mg/d), hypertensive controlled with Losartan 25 mg b.i.d. She received Pentoxifillin for 2 months while she received steroid without any effect and along with statins.

Her 11g/day of proteinuria failed to respond to steroid alone and steroid+MMF therapy but had partial response to steroid and cyclosporine with proteinuria improving to 5 g/day. Her renal function continues to be normal. What should be the next step to treat this patient?

Posted in Glomerular Diseases, asked by M Reza Khatami, 3 months ago. 139 hits.


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