Analysis of Tacrolimus Combined with Glucocorticoids for Refractory Nephrotic Syndrome
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Keywords

Nephrotic syndrome
Refractory
Tacrolimus
Glucocorticoids
Kidney function

DOI

10.26689/jcnr.v8i11.8984

Submitted : 2024-10-29
Accepted : 2024-11-13
Published : 2024-11-28

Abstract

Objective: To analyze changes in liver and kidney function and lipid metabolism in patients with refractory nephrotic syndrome (RNS) after receiving different treatments. Methods: A total of 64 patients treated in the Wuwei Hospital of Traditional Chinese Medicine from January 2018 to January 2021 were included in this study. All subjects were diagnosed with RNS and randomly assigned to groups: a control group (32 cases) and an observation group (32 cases). The control group received cyclophosphamide + glucocorticoids, while the observation group received tacrolimus + glucocorticoids, both for six months. The various indicators of the two groups were compared. Results: After six months of treatment, the overall clinical efficacy rate of the observation group was significantly higher than that of the control group. Six months post-treatment, levels of serum ALT, AST, BUN, SCr, 24 h UTP, TG, and TC were reduced in both groups compared to baseline levels, with reductions more pronounced in the observation group. Serum ALB levels increased in both groups, with a more significant increase in the observation group. Statistical analysis showed these differences were significant (P < 0.05). There were no significant changes in FBG levels in either group (P > 0.05). Conclusion: For RNS patients, treatment with tacrolimus combined with glucocorticoids significantly reduces liver function damage, improves kidney function and lipid metabolism, and enhances clinical efficacy.

References

Guo HL, Li L, Xu ZY, et al., 2021, Steroid-resistant Nephrotic Syndrome in Children: A Mini-review on Genetic Mechanisms, Predictive Biomarkers and Pharmacotherapy Strategies. Curr Pharm Des, 27(2): 319–329. https://doi.org/10.2174/1381612826666201102104412

Jiang N, 2022, Clinical Observation of Prednisone Combined with Cyclophosphamide Pulse Therapy for Refractory Nephrotic Syndrome. Guide of China Medicine, 20(36): 76–78.

Qiu LR, Zhang RJ, Liao LP, 2023, Observation of the Clinical Effects of Tacrolimus Combined with Glucocorticoids in the Treatment of Refractory Nephrotic Syndrome. Medical Theory and Practice, 36(6): 979–981.

Expert Group on Immunosuppressive Therapy for Adult Nephrotic Syndrome in China, 2014, Expert Consensus on Immunosuppressive Therapy for Adult Nephrotic Syndrome in China. Chinese Journal of Nephrology, 30(6): 467–474.

Zhang DL, Luo L, Zheng LR, et al., 2020, Rituximab Should Not be Used as A Salvage Therapy for Secondary Refractory Nephrotic Syndrome. Chinese General Practice, 23(36): 4645–4650.

Ni JY, Zhai WS, Li L, et al., 2022, Clinical Efficacy of Sequential Therapy with Yiqi Huayu Qingre Formula Based on Hormone Combined with Cyclophosphamide for Children with Refractory Nephrotic Syndrome. China Journal of Traditional Chinese Medicine and Pharmacy, 37(12): 7521–7525.

Chen JT, 2019, Experiences on the Application Value of Tacrolimus and Glucocorticoids in Refractory Nephrotic Syndrome. Guide of China Medicine, 17(35): 73–74.

Ding W, 2021, Analysis of Clinical Efficacy and Incidence of Adverse Reactions in Tacrolimus Combined with Glucocorticoids for the Treatment of Refractory Nephrotic Syndrome. Chinese Journal of Modern Drug Application, 15(6): 178–180.

Zhang D, 2020, Clinical Observation of Tacrolimus Combined with Glucocorticoids in the Treatment of Refractory Nephrotic Syndrome. Chinese Journal of Modern Drug Application, 14(10): 139–141.

Tan HJ, 2021, Clinical Efficacy and Safety of Tacrolimus Combined with Glucocorticoids in the Treatment of Refractory Nephrotic Syndrome. Journal of Clinical Rational Drug Use, 14(23): 95–96.

Deng DY, Xu L, Liu K, 2021, Effects of Tacrolimus Capsules Combined with Glucocorticoids on Liver and Kidney Function, Glucose, and Lipid Metabolism in Patients with Refractory Nephrotic Syndrome. Journal of Clinical Rational Drug Use, 14(32): 112–114.

Liu ZG, Liu YY, Chai FX, et al., 2020, Experience on the Clinical Value of Tacrolimus + Glucocorticoids in the Treatment of Nephrotic Syndrome. Journal of Aerospace Medicine, 31(5): 526–527.