Related Factors Of The Tacrolimus Treatment Outcomes In Patients With Idiopathic Membranous Nephropathy

Objective:To investigate the clinical and pathological factors affecting the effect of tacrolimus in patients with idiopathic membranous nephropathy.Methods: A total of 43 patients who were diagnosed with idiopathic membranous nephropathy by renal biopsy and followed-up for at least six months in the Department of Nephrology of Shengjing Hospital Affiliated to China Medical University from November 2011 to October 2017 were retrospectively analyzed and their clinical and pathological data were collected.All the patients were treated with tacrolimus combined glucocorticoid.They were divided into invalid group and effective group according to the patient's therapeutic effect.The independent samples t-test,chi-square test and multivariate logistic binary stepwise regression analysis were used to analyze the clinical and pathological factors influencing the effect of tacrolimus treatment.Results:43 patients received tacrolimus treatment,including 33 men and 10 women.Among them,14 cases were in the effective group and 29 cases were in the ineffective group.After treatment with tacrolimus combined glucocorticoid,the number of patients with hypertension in the ineffective group was significantly more than that in the effective group(?2 = 7.525,P <0.05),while the patients in the ineffective group were older than those in the effective group(?2 = 12.444,P <0.05).Then the binary logistic regression was used to analyze the history of hypertension and the age of onset.Multivariate logistic two stepwise regression analysis showed that the hypertension history is an independent risk factor for tacrolimus treatment response in patients with idiopathic membranous nephropathy at the time of initial treatment(?=-1.968,OR=0.140,95%CI=0.023-0.863,P<0.05).Conclusion: Tacrolimus is an effective treatment option for the treatment of IMN.The combination of hypertension at initial treatment is a risk factor that affects the therapeutic effect of tacrolimus,and advanced age may also affect the prognosis and needs further confirmation.