EFFECTIVENESS OF IMMUNOSUPPRESSANTS ALONG WITH ACEI/ARBS IN TREATING PROTEINURIA IN PATIENTS WITH SOLITARY KIDNEY POST NEPHRECTOMY
Objective: To ascertain the effectiveness of immunosuppressants along with ACEI and /or ARBS in proteinuria in patients with solitary kidney post nephrectomy. Study Design: Prospective quasi-experimental study. Place and Duration of Study: Combined Military Hospital Peshawar and Multan, from 2010...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Army Medical College Rawalpindi
2018-10-01
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| Series: | Pakistan Armed Forces Medical Journal |
| Subjects: | |
| Online Access: | https://www.pafmj.org/index.php/PAFMJ/article/view/2290/1986 |
| _version_ | 1818983038257725440 |
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| author | Nadeem Azam Fuad Ahmad Siddiqi Koukab Javed Batool Butt |
| author_facet | Nadeem Azam Fuad Ahmad Siddiqi Koukab Javed Batool Butt |
| author_sort | Nadeem Azam |
| collection | DOAJ |
| description | Objective: To ascertain the effectiveness of immunosuppressants along with ACEI and /or ARBS in proteinuria
in patients with solitary kidney post nephrectomy.
Study Design: Prospective quasi-experimental study.
Place and Duration of Study: Combined Military Hospital Peshawar and Multan, from 2010 to 2016.
Subjects and Methods: The sample population comprised of 07 cases of post nephrectomy solitary kidney
developing proteinuria from 2010-2016 reporting to hospitals. Patients were given initially ACEI and/or ARBS to
lower proteinuria for three months. They were followed up to see for complete or partial remission. Deltacortil
1mg/kg max 60mg/day along with ACEI and /or ARBS was added to patients who didn’t go into remission.
Results: Out of 7 patients, 3 (42.9%) were males and 4 (57.1%) were female patients. Addition of deltacortil
1mg/kg max 60mg/day along with ACEI and /or ARBS reduced proteinuria to less than 1 gram in 3 patients
(2 males and 1 female) and less than 300mg in 4 patients (1 male and 3 females).There was a reduction in the
mean 24hrs urinary protein excretion as a whole from the baseline 2.33 ± 0.84 g/24 hrs to 0.48 ± 0.33 g/24 hrs.
Remission was achieved on the average in three months and maintenance on tapering doses for 12 months.
Cyclosporine was used in three cases who relapsed on tapering steroids and remission was achieved with 5-10mg
steroids and 100-200mg of cyclosporine.
Conclusion: Non respondent patients with solitary kidney developing proteinuria being treated with ACEI and
/or ARBS had good chance to lower their proteinuria with steroids. Relapses even with steroids responded to
cyclosporine. |
| first_indexed | 2024-12-20T17:56:45Z |
| format | Article |
| id | doaj.art-a3241e8e34414ed4b156471bccc7a9d5 |
| institution | Directory Open Access Journal |
| issn | 0030-9648 2411-8842 |
| language | English |
| last_indexed | 2024-12-20T17:56:45Z |
| publishDate | 2018-10-01 |
| publisher | Army Medical College Rawalpindi |
| record_format | Article |
| series | Pakistan Armed Forces Medical Journal |
| spelling | doaj.art-a3241e8e34414ed4b156471bccc7a9d52022-12-21T19:30:45ZengArmy Medical College RawalpindiPakistan Armed Forces Medical Journal0030-96482411-88422018-10-0168511941198EFFECTIVENESS OF IMMUNOSUPPRESSANTS ALONG WITH ACEI/ARBS IN TREATING PROTEINURIA IN PATIENTS WITH SOLITARY KIDNEY POST NEPHRECTOMYNadeem Azam0Fuad Ahmad Siddiqi1Koukab Javed2Batool Butt3College of Physician and Surgeon Pakistan, Karachi PakistanCollege of Physician and Surgeon Pakistan, Karachi PakistanCollege of Physician and Surgeon Pakistan, Karachi PakistanCollege of Physician and Surgeon Pakistan, Karachi PakistanObjective: To ascertain the effectiveness of immunosuppressants along with ACEI and /or ARBS in proteinuria in patients with solitary kidney post nephrectomy. Study Design: Prospective quasi-experimental study. Place and Duration of Study: Combined Military Hospital Peshawar and Multan, from 2010 to 2016. Subjects and Methods: The sample population comprised of 07 cases of post nephrectomy solitary kidney developing proteinuria from 2010-2016 reporting to hospitals. Patients were given initially ACEI and/or ARBS to lower proteinuria for three months. They were followed up to see for complete or partial remission. Deltacortil 1mg/kg max 60mg/day along with ACEI and /or ARBS was added to patients who didn’t go into remission. Results: Out of 7 patients, 3 (42.9%) were males and 4 (57.1%) were female patients. Addition of deltacortil 1mg/kg max 60mg/day along with ACEI and /or ARBS reduced proteinuria to less than 1 gram in 3 patients (2 males and 1 female) and less than 300mg in 4 patients (1 male and 3 females).There was a reduction in the mean 24hrs urinary protein excretion as a whole from the baseline 2.33 ± 0.84 g/24 hrs to 0.48 ± 0.33 g/24 hrs. Remission was achieved on the average in three months and maintenance on tapering doses for 12 months. Cyclosporine was used in three cases who relapsed on tapering steroids and remission was achieved with 5-10mg steroids and 100-200mg of cyclosporine. Conclusion: Non respondent patients with solitary kidney developing proteinuria being treated with ACEI and /or ARBS had good chance to lower their proteinuria with steroids. Relapses even with steroids responded to cyclosporine.https://www.pafmj.org/index.php/PAFMJ/article/view/2290/1986immunosuppressantspost nephrectomyproteinuria |
| spellingShingle | Nadeem Azam Fuad Ahmad Siddiqi Koukab Javed Batool Butt EFFECTIVENESS OF IMMUNOSUPPRESSANTS ALONG WITH ACEI/ARBS IN TREATING PROTEINURIA IN PATIENTS WITH SOLITARY KIDNEY POST NEPHRECTOMY Pakistan Armed Forces Medical Journal immunosuppressants post nephrectomy proteinuria |
| title | EFFECTIVENESS OF IMMUNOSUPPRESSANTS ALONG WITH ACEI/ARBS IN TREATING PROTEINURIA IN PATIENTS WITH SOLITARY KIDNEY POST NEPHRECTOMY |
| title_full | EFFECTIVENESS OF IMMUNOSUPPRESSANTS ALONG WITH ACEI/ARBS IN TREATING PROTEINURIA IN PATIENTS WITH SOLITARY KIDNEY POST NEPHRECTOMY |
| title_fullStr | EFFECTIVENESS OF IMMUNOSUPPRESSANTS ALONG WITH ACEI/ARBS IN TREATING PROTEINURIA IN PATIENTS WITH SOLITARY KIDNEY POST NEPHRECTOMY |
| title_full_unstemmed | EFFECTIVENESS OF IMMUNOSUPPRESSANTS ALONG WITH ACEI/ARBS IN TREATING PROTEINURIA IN PATIENTS WITH SOLITARY KIDNEY POST NEPHRECTOMY |
| title_short | EFFECTIVENESS OF IMMUNOSUPPRESSANTS ALONG WITH ACEI/ARBS IN TREATING PROTEINURIA IN PATIENTS WITH SOLITARY KIDNEY POST NEPHRECTOMY |
| title_sort | effectiveness of immunosuppressants along with acei arbs in treating proteinuria in patients with solitary kidney post nephrectomy |
| topic | immunosuppressants post nephrectomy proteinuria |
| url | https://www.pafmj.org/index.php/PAFMJ/article/view/2290/1986 |
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