Archive | 2021
Effect of Moshen Digui prescription for treatment of idiopathic membranous nephropathy—protocol for a randomized, controlled, and single-blind trial
Abstract
Membranous nephropathy (MN) has been the leading cause of the nephrotic syndrome in nondiabetic adults (1-3). MN can be induced by many secondary causes, such as drugs, infections, and underlying diseases (4). However, most patients of MN are idiopathic (5). IMN is a kind of antibody-mediated autoimmune disease, which can be diagnosed by renal biopsy. The characterized renal biopsy of IMN is deposition of immune complex along the glomerular basement membrane. Moreover, IMN patients has high risk for progressive deterioration of renal function. Research found that 30–40% IMN patients could develop into ESRD (6). As we know, ACEI/ARB is the basic therapy for IMN. Research showed that ACEI/ARB has beneficial effect on decreasing proteinuria for IMN patients with non-nephrotic-range proteinuria (7,8). When patients proteinuria ≥4 g/24 h after 6-month conservative therapy, they should be applied immunosuppressive therapy (9). Cyclosporine and tacrolimus, mycophenolate mofetil (MMF), rituximab, and adrenocorticotropic hormone (ACTH) are recommended for IMN patients for immunosuppressive therapies (10). However the immunosuppressive therapies have side effects such as infection, tumor, and so on. Moreover, there are many IMN patients has high level of proteinuria and high risk of progression to ESRD after these active treatments. Thus, Study Protocol