Steroid Therapy in Initial Treatment of Idiopathic Membranous Nephropathy

Background : The introduction of renin angiotensin system blockers (RASB) might challenge the previous results of immunosuppressive therapies in idiopathic membranous nephropathy (IMN). We investigated the effectiveness of steroids in addition to treatment including RASB. Methods : The data of patients were retrieved retrospectively. The patients who had been administered any other immunosuppressive drug other than steroids were not included. All the patients were on conventional anti-proteinuric treatments, including RASB. Results: 29 patients were included (19 of them in the steroid group, follow-up period: 15.4 +/- 7.2 months). Thirteen (44.8%) of them had complete remission (9 in the steroid group). Twelve (41.4%) were unresponsive (6 in each group). In the steroid group, 13 (68.4%) patients had either complete or partial remission whereas this number was only 4 (40%) in the others (p>0.05). None of the patients died or required renal replacement therapy. Discussion : Our study did not support the idea of extra benefit of steroid treatment in IMN in addition to conventional treatment. Steroid treatment only increased the partial remission ratio in our study that was in concordance with the previous randomized controlled studies performed in the pre-RASB era. Conclusion : Steroids added to RASB do not provide additional benefit in IMN patients.