The outcomes of primary membranous nephropathy treated with cyclophosphamide are superior to calcineurin inhibitors in patients with renal vascular lesions: A multi-center retrospective cohort study

doi:10.1016/j.intimp.2024.113379

科研成果详情

题名	The outcomes of primary membranous nephropathy treated with cyclophosphamide are superior to calcineurin inhibitors in patients with renal vascular lesions: A multi-center retrospective cohort study
作者	Zhang, Yifan 1,2; Xie, Jianteng 1,3; Lu, Min 1,3; Zhang, Shaogui 1; Fan, Li 1; Jiang, Qifeng 5; Wang, Yanhui1,6; Li, Sheng 1,3; Chen, Chaosheng6; Hok Him, Yau 1; Chen, Zujiao 1; Li, Qiuling 1,4; Li, Ruizhao 1; Wang, Wenjian 1
发表日期	2024-12-25
发表期刊	International Immunopharmacology 影响因子和分区
语种	英语
原始文献类型	Article
关键词	Membranous nephropathy Propensity score-matching Renal pathology Vascular lesion
摘要	Background: The difference of the outcomes of primary membranous nephropathy (PMN) with renal vascular lesions treated with cyclophosphamide (CTX) compared to calcineurin inhibitors (CNIs) remains undetermined. Methods: 872 patients with PMN finished CNIs or CTX-based therapy between 2003 and 2018 from three centers in China were followed up at most to 120 months. A propensity-score matched (PSM) method was used to analyze the difference of outcomes between those receiving CTX- and CNIs-based therapy. Primary endpoints were defined as 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, no significant difference of proteinuria complete remission rate was found between 126 paired patients (HR, 1.32; 95 % CI, 0.95 to 1.83; p = 0.10). However, CTX-based therapy was associated with significantly better renal survival compared to CNI-based therapy. (median, 156 months vs. 108 months; hazard ratio [HR], 0.31; 95 % confidence interval [CI]0.16 to 0.61; p = 0.001). 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 0.50; p = 0.002;), arteriosclerosis (HR, 0.31; 95 % CI 0.15 to 0.62; p = 0.001), or hypertension (HR, 0.21; 95 % CI 0.08 to 0.53; p = 0.001). Conclusions: CTX-based therapy exhibited a significantly improved composite endpoint of PMN patients with vascular lesions compared to CNIs-based regime.
资助项目	National Natural Science Foundation[82,170,731,81,470,974];High-level Hospital Construction Project of Guangdong Province[DFJH201908];
ISSN	1567-5769
EISSN	1878-1705
卷号	143 期号:Pt 2
DOI	10.1016/j.intimp.2024.113379
收录类别	SCOPUS ; PUBMED
URL	查看原文
PubMed ID	39418737
SCOPUSEID	2-s2.0-85206342113
通讯作者地址	[Wang, Wenjian]Division of Nephrology,Guangdong Provincial People's Hospital,Guangdong Academy of Medical Sciences,106 Zhongshan Er Road, Main Building, Room 1435, Guangdong,Guangzhou,510080,China
Scopus学科分类	Immunology and Allergy;Immunology;Pharmacology
SCOPUS_ID	SCOPUS_ID:85206342113
引用统计
文献类型	期刊论文
条目标识符	https://kms.wmu.edu.cn/handle/3ETUA0LF/220896
专题	附属第二医院第一临床医学院（信息与工程学院）、附属第一医院附属第一医院其他_定理临床学院（温州市中心医院）
通讯作者	Wang, Wenjian
作者单位	1.Division of Nephrology,Guangdong Provincial People's Hospital,Guangdong Academy of Medical Sciences,Guangzhou,510080,China; 2.Division of Nephrology,Wenzhou Central Hospital,The Dingli Clinical College of Wenzhou Medical University,The Second Affiliated Hospital of Shanghai University,Wenzhou,325000,China; 3.School of Medicine,South China University of Technology,Guangzhou,510006,China; 4.Shantou University Medical College,Shantou,515041,China; 5.Division of Renal Pathology,Guangzhou KingMed Diagnostic Laboratory LTD,Guangzhou,510320,China; 6.Division of Nephrology,the First Affiliated Hospital of Wenzhou Medical University,Wenzhou,325000,China
第一作者单位	附属第二医院; 定理临床学院（温州市中心医院）
推荐引用方式 GB/T 7714	Zhang, Yifan,Xie, Jianteng,Lu, Min,et al. The outcomes of primary membranous nephropathy treated with cyclophosphamide are superior to calcineurin inhibitors in patients with renal vascular lesions: A multi-center retrospective cohort study[J]. International Immunopharmacology,2024,143(Pt 2).
APA	Zhang, Yifan., Xie, Jianteng., Lu, Min., Zhang, Shaogui., Fan, Li., ... & Wang, Wenjian. (2024). The outcomes of primary membranous nephropathy treated with cyclophosphamide are superior to calcineurin inhibitors in patients with renal vascular lesions: A multi-center retrospective cohort study. International Immunopharmacology, 143(Pt 2).
MLA	Zhang, Yifan,et al."The outcomes of primary membranous nephropathy treated with cyclophosphamide are superior to calcineurin inhibitors in patients with renal vascular lesions: A multi-center retrospective cohort study".International Immunopharmacology 143.Pt 2(2024).