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07 February 2021: Review Articles

A Review of the Current Practice of Diagnosis and Treatment of Idiopathic Membranous Nephropathy in China

Lianzhong Wu 12AE* , Jin Lai 12B* , Yixin Ling 12C , Yiqin Weng 12B , Shujuan Zhou 1D , Siqi Wu 2D , Songfu Jiang 1D , Xiaokai Ding 3D , Xin Jin 4EFG* , Kang Yu 1EF* , Yi Chen 1EF*

DOI: 10.12659/MSM.930097

Med Sci Monit 2021; 27:e930097

Table 2 A summary of the advantages and disadvantages of various treatment approaches for idiopathic membranous nephropathy in China.

Renin-angiotensin system inhibitorsReduced proteinuria; renal protectionHigh potassium, AKI; lack of evidence regarding long-term prognosis
GlucocorticoidsInexpensive and easy to obtain; considered to have some effect on Chinese patientsLack of RCT evidence and recommendations; adverse effects with long-term use
CyclophosphamideReduced proteinuria; renal function protection; can be used in severe casesAdverse reactions, especially gonadal suppression; lack of evidence for oral and intravenous use
Calcineurin inhibitorsReduced proteinuria; renal protectionPrice; nephrotoxicity; high recurrence rate (CSA); hyperglycemia (TAC)
Adrenocorticotropic hormoneReduced proteinuria; renal protectionPrice; difficult to obtain; limited clinical evidence; adverse reactions
RituximabAlternative therapy for patients with poor response to conventional therapy; potential as first-line therapyPrice; a certain probability of nonresponse; adverse reactions
Mycophenolate mofetilAlternative therapy for patients with poor response to conventional therapyLack of RCT evidence; price; adverse reactions
Traditional Chinese medicineImproved symptoms; increased efficacy of conventional drugs; reduced adverse reactions to conventional drugsLack of RCT evidence and pharmacological mechanism research
AKI – acute kidney injury; CSA – cyclosporine A; RCT – randomized controlled trial; TAC – tacrolimus.

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750