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Tacrolimus in resistant primary membranous nephropathy--a report of 3 cases
C C Szeto1, C B Leung, F M M Lai
1Department of Medicine and Therapeutics, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, Hong Kong.
Aim:
To study the efficacy and safety of tacrolimus in primary membranous nephropathy.
Method:
We describe 3 patients with primary membranous nephropathy who were either resistant to or could not tolerate steroid with or without cytotoxic agents. They were treated with tacrolimus 0.2 mg/kg/day for 6 months. The dosage of tacrolimus was adjusted to keep a whole blood tacrolimus level of 5-10 ng/ml.
Results:
One patient had almost complete disappearance of proteinuria while the other 2 had at least 50% reduction in proteinuria. Proteinuria increased again in 2 of the patients after tacrolimus was stopped, but in neither of them proteinuria returned to the pretreatment level 6 months after tacrolimus was stopped.
Conclusion:
We conclude that tacrolimus may have a modest efficacy in the treatment of resistant membranous nephropathy.