Mesangialproliferative glomerulonephritis treatment

The disease caused by nephrotic syndrome is often more difficult. Small doses the next day prednisone therapy may help to improve renal function. West et al use the next day oral steroids long-term treatment, biopsy before and after treatment, the results prove this method is conducive to the survival of the kidney. At present, most nephrologists only symptomatic treatment.
Treatment of type Ⅰ, in addition to glucocorticoids, but also with other drugs such as immune suppression drugs and anticoagulants.
MPGN patients of all ages, with normal renal function showed only mild asymptomatic proteinuria without receiving steroids, immunosuppressive drug therapy. Only every 3 to 4 months follow-up, close observation of renal function, proteinuria and blood pressure control. Adults and children with primary MPGN patients, urinary protein> 3g / d, renal damage and biopsy of renal interstitial disease may be given hormones, immunosuppressive drug therapy.
May be effective in the treatment of 6 to 12 months for proteinuria (> 3g / d) or impaired renal function in children with primary MPGN patients, large doses of glucocorticoids next day 40mg/m2. If that does not stop taking glucocorticoids, we recommend close follow-up, focusing on conservative treatment (ie, control of blood pressure, applied to reduce urinary protein drugs and correction of metabolic disorders).
Proteinuria (> 3g / d) or adults with impaired renal function in patients with primary MPGN, should be given aspirin (325mg / d), dipyridamole (dipyridamole) treatment (75 to 100mg, 2 times / d), or both combined 12 months if the treatment plan is invalid is disabled. Great importance to be able to slow the decline in kidney function factors and close follow-up should be part of the treatment plan.
Several treatment studies have reported the next day, or daily oral corticosteroids, intravenous high-dose glucocorticoids, and the combined application of the results: a more rigorous research confirmed: children MPGN, hormone therapy in slowing renal ball filtration rate (GFR) decline in the effective and stable renal function. Most of the 80 cases were type Ⅰ MPGN, prednisone (prednisone) 40mg/m2 every other day oral average treatment time of 13 months, 61% of treatment group children at the research stage renal stable, while The placebo group only 12%. Proved children MPGN patients with glucocorticoid is effective. Studies have shown that children's of MPGN early application of high-dose prednisone (prednisone) can effectively shorten the course of the disease. But remains controversial, still with a rigorous randomized controlled trials to verify.
Danadio and other study dipyridamole (dipyridamole), aspirin and warfarin in MPGN treatment on renal outcome (including the impact of urinary protein excretion rate) and platelet half-life (bleeding tendency). Lower urinary protein excretion rate, but no significant changes in GFR. Cattran and other 59 cases of MPGN patients taking cyclophosphamide, warfarin and dipyridamole (dipyridamole) the efficacy of the treatment time of 18 months. The detailed description of how the research only I MPGN patients will have a clearer treatment of type Ⅱ disease is not strong enough evidence to conclude.
Type Ⅱ there is no effective treatment. Reasonable solution to the treatment of this disease is still controversial, treatment options should carefully weigh the efficacy of the treatment of adverse reactions. Leaves any higher recommended using the following program: dipyridamole (dipyridamole) 50 ~ 300mg / d, divided into three doses. If nephrotic syndrome, the available symptomatic of the way and try the standard regimen of hormones, to be tapered to maintenance dose (the next day morning serving Dayton prednisone 0.4mg/kg), and then to maintain the application a longer period, such ashave high blood pressure, it is recommended to use the new staircase method antihypertensive therapy. In the implementation of treatment programs should be closely observed side effects, to exceed and achieve therapeutic effect.
Other treatment, including lipid-lowering, ACE inhibitors, the ARB, low molecular weight heparin, in recent years, scholars have reported that mycophenolate mofetil (MMF) treatment of the disease, showing initial results, but the number of cases was small, and the lack of control and long-term observational study.
In addition, the application of cytotoxic drugs, plasmapheresis methods, traditional Chinese medicine treatment in some studies the treatment of some efficacy.
In deciding what type of patients when the treatment, the clinician must consider the pros and cons of the expected course and outcome of the disease, and treatment, renal insufficiency development and drug treatment due to poor compliance.