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  1. Venkat
  2. General Nephrology Questions
  3. Thursday, 15 August 2013
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Hi!

What the next line of management for IgA Nephropathy with M1 S1 T0, E0 score , creat 88mmol/l continues to have 4.5 gms of proteinuria after 9 months of Max tolerable doses of ACEI+ARBS combination, fish oil and oral prednisolone 40mg/m2, EM not available, is cucophosphamode / Cyclosporin an option now just as MCD

Thanks

Venkat- Fellow
  Toronto, ON, Canada
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Responses (2)
Accepted Answer Pending Moderation
I mean cyclophosphamide or cyclosporin an option for the above case ??
  1. more than a month ago
  2. General Nephrology Questions
  3. # 1
Accepted Answer Pending Moderation
Hello,

There are no perfect studies to address this issue but it seems that there might some activity in a a regimen that included:

Prednisolone (40 mg per day tapered to 10 mg/day by two years) plus low-dose cyclophosphamide (1.5 mg/kg per day) for the initial three months followed by low-dose azathioprine (1.5 mg/kg per day) [reference included below].

As you seem to be writing from Toronto, you could also discuss this case with Drs. Heather Reich or Dan Cattran.

Dr. Jordan Weinstein
References
  1. http://www.ncbi.nlm.nih.gov/pubmed/11752031
  1. more than a month ago
  2. General Nephrology Questions
  3. # 2
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