THE EFFICACY OF CYCLOSPORIN A TREATMENT IN CASES WITH PRIMARY GLOMERULONEPHRITIS THAT ARE UNRESPONSIVE TO CONVENTIONAL IMMUNSUPRESSIVE THERAPY

Immune system activation play an important role in the pathogenesis of primary glomerulonephritis. Although various immunsupressive agents have been used in the treatment of primary glomerulonephritis, still there is not an efficacious therapy model. In this study we aimed to investigate the efficacy of cyclosporin A on primary glomerulonephritis patients who did not respond to conventional immunsupressive therapy. Eleven Membranous glomerulonephritis (MGN), 6 Focal segmental glomerulosclerosis (FSGS), 4 Membranoproliferative glomerulonephritis (MPGN) and 4 Minimal change disease (MCD) total 25 patients were studied. Despite the treatment of prednisolone, prednisolone + cyclophosphamide or prednisolone + azathioprine at least for six months, persistance of proteinuria or progressive renal function loss accepted as resistance to therapy. Cyclosporin A 5 mg/kg +10 mg prednisolone was given at least for six months to these conventional therapy resistant patients. We compared urea, creatinine, creatinine clearance, proteinuria, serum total protein and serum albumin levels at the beginning of conventional therapy; at the end of conventional therapy = beginning of cyclosporin A and at the end of cyclosporin A treatment. Seven (%28) patients complete remission, 9 (%36) patients partial remission and 9 (%36) patients considered failure to cyclosporin A treatment. Complete or partial remission was observed in 7 of 11 (%63) MGN patients. These results indicate that; cyclosporin A might be an alternative therapy model for primary glomerulonephritis patients that are resistant to conventional therapy.