{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T05:05:00Z","timestamp":1781327100775,"version":"3.54.1"},"reference-count":35,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2017,12,17]],"date-time":"2017-12-17T00:00:00Z","timestamp":1513468800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100007155","name":"Medical Research Council Canada","doi-asserted-by":"publisher","award":["MR\/J010847\/1"],"award-info":[{"award-number":["MR\/J010847\/1"]}],"id":[{"id":"10.13039\/501100007155","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nephrology"],"published-print":{"date-parts":[[2018,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Primary membranous nephropathy is associated with progression to end stage renal diseasein some patients. Standard therapy with cyclical cyclophosphamide and corticosteroids can be associated with significant adverse effects. We aimed to assess immunological and clinical response with intravenous pulse cyclophosphamide and oral steroids in patients with severe nephrotic syndrome \u2013 in a prospective observational cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 17 consecutive patients (nine new\u2010incident and eight relapses) with severe nephrotic syndrome received monthly intravenous pulse cyclophosphamide and oral steroids after failure to achieve remission with supportive therapy. Immunosuppressive therapy was discontinued at 6 months or earlier if proteinuria regressed to &lt;100\u00a0mg\/mmol and patients were followed for 12 months. Achievement of partial remission was primary outcome; changes in clinical parameters and anti\u2010PLA<jats:sub>2<\/jats:sub>R were secondary outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Dose of cyclophosphamide received was 5.4\u00a0g in New\u2010incident patients and 4.2\u00a0g in patients with relapses. All 17 patients achieved partial remission within 6 months: proteinuria improved from 656 to 102\u00a0mg\/mmol at 6 months and 55\u00a0mg\/mmol at 12\u00a0months (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001); eGFR improved from 31 to 48\u00a0mL\/min per 1.73\u00a0m<jats:sup>2<\/jats:sup> at 6 months and 45\u00a0mL\/min per 1.73\u00a0m<jats:sup>2<\/jats:sup> at 12 months (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.05). Anti\u2010PLA<jats:sub>2<\/jats:sub>R levels reduced from 244 to 10\u00a0U\/L at 6 months and 10\u00a0U\/L at 12 months (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001). Two out of nine patients in the New\u2010incident group developed subsequent relapse. Cumulative doses of cyclophosphamide and steroids that patients received was about half of the standard regime.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Pulse cyclophosphamide with oral steroids induced immunological and clinical partial remission at significantly reduced doses in primary membranous nephropathy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nep.12955","type":"journal-article","created":{"date-parts":[[2016,10,25]],"date-time":"2016-10-25T03:22:54Z","timestamp":1477365774000},"page":"60-68","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Intravenous pulse cyclophosphamide and steroids induce immunological and clinical remission in New\u2010incident and relapsing primary membranous nephropathy"],"prefix":"10.1111","volume":"23","author":[{"given":"Durga Anil K","family":"Kanigicherla","sequence":"first","affiliation":[{"name":"Manchester Institute of Nephrology and Transplantation Central Manchester University Hospitals NHS Foundation Trust  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Hamilton","sequence":"additional","affiliation":[{"name":"Manchester Institute of Nephrology and Transplantation Central Manchester University Hospitals NHS Foundation Trust  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krystyna","family":"Czapla","sequence":"additional","affiliation":[{"name":"Manchester Institute of Nephrology and Transplantation Central Manchester University Hospitals NHS Foundation Trust  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul EC","family":"Brenchley","sequence":"additional","affiliation":[{"name":"Manchester Institute of Nephrology and Transplantation Central Manchester University Hospitals NHS Foundation Trust  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,12,17]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfq665"},{"key":"e_1_2_7_3_1","first-page":"139","article-title":"KDIGO clinical practice guideline for glomerulonephritis","volume":"2","author":"KDIGO G. 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