Management of idiopathic membranous nephropathy with intravenous cyclophosphamide

Manejo de la nefropatía membranosa idiopática con ciclofosfamida endovenosa

Introduction: primary glomerular diseases represent the third cause of chronic kidney disease, being membranous nephropathy (MN) the most frequent cause of nephrotic syndrome in Colombia. Intravenous cyclophosphamide is a treatment option for MN, which has not been described in our population. Objective: to determine the response of idiopathic membranous nephropathy (IMN) to IV cyclophosphamide at Hospital de San José de Bogotá from January 2000 to January 2019.  Methodology: case series study which included all adult patients with IMN diagnosed by renal biopsy treated with IV cyclophosphamide in the described period. Results: eight patients were included in the study of which 50% were women, median age at presentation was 32.5 (IQR: 26-45) years. 100% of patients experienced partial or complete remission, as follows: 62.5% complete remission and 37.5% partial remission. Increase in the median glomerular filtration rate after the use of IV cyclophosphamide was 9 (IQR: 1-20.2) mL/min/1.73 m². Renal survival rate was 100% and the relapse rate was 12.5%. Conclusions: monthly IV cyclophosphamide is a treatment option for IMN, attaining 100% partial or complete remission, using a median cumulative dose of 93 (IQR: 65.6-125) mg/k.  

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