Idiopathic membranous nephropathy (IMN) is the most common cause of nephrotic syndrome in adults. Universal consensus regarding the need for and the modality of therapy has not been formed because of a lack of controlled trials of sufficient size, quality, and duration. This study compared the effect of a 6-mo course of alternating prednisolone and cyclophosphamide with supportive treatment in adults with nephrotic syndrome caused by IMN on doubling of serum creatinine, development of ESRD, and quality of life in a randomized, controlled trial. Patients were followed up for 10 yr. Data were analyzed on an intention-to-treat basis. A total of 93 patients completed the study. Of the 47 patients who received the experimental protocol, 34 achieved remission (15 complete and 19 partial), compared with 16 (five complete, 11 partial) of 46 in the control group (P < 0.0001). The 10-yr dialysis-free survival was 89 and 65% (P ‫؍‬ 0.016), and the likelihood of survival without death, dialysis, and doubling of serum creatinine were 79 and 44% (P ‫؍‬ 0.0006) in the two groups. Treated patients exhibited significantly lower prevalence of edema, hypertension, hypoalbuminemia, hyperlipidemia that required therapy, angiotensin-converting enzyme inhibitor/angiotensin II receptor blocker use, and better quality of life on follow-up. The incidence of infections was similar in the two groups. In conclusion, untreated IMN with nephrotic syndrome is associated with a high risk for deterioration of renal function. A 6-mo regimen of cyclophosphamide and steroids induces remissions in a high proportion, arrests progression of renal insufficiency, and improves quality of life. 18: 189918: -190418: , 200718: . doi: 10.1681 I diopathic membranous nephropathy (IMN) is the most common cause of nephrotic syndrome in adults (1). Although clinical trials on therapy for this disease have spanned more than two decades, universal consensus regarding the need for and the modality of therapy to decrease proteinuria and halt the progression of renal disease does not exist (2). A number of therapeutic measures have been tried, including nonspecific antiproteinuric agents; corticosteroids, either alone or with alkylating agents; cyclosporine; intravenous Ig; mycophenolate mofetil; and rituximab (3-16). The only regimen that showed a clear short-and long-term benefit is the one that consists of a 6-mo course of alternating months of oral chlorambucil and corticosteroids (15,17). Others, however, have pointed to the relatively benign course of IMN (18) and favor a conservative approach. A recent systematic review (19) failed to find a beneficial effect of treatment on renal or patient survival. J Am Soc NephrolA major lacuna that limits the value of this meta-analysis is the lack of controlled trials of sufficient size, quality, and duration. Because ESRD usually develops only after 5 to 10 yr, studies that aim to evaluate the effect of treatment on development of ESRD need a sufficiently long follow-up. We conducted a randomized, controlled trial (R...

GSK1278863 induced an effective EPO response and stimulated non-EPO mechanisms for erythropoiesis in anemic non-dialysis-dependent and dialysis-dependent patients with CKD.

Nephrotic Syndrome (NS) is a common childhood illness characterized by massive proteinuria, hyperlipidemia, hypoalbuminemia & edema. NS is a disease of relapse and it is a major problem to manage the cases with frequent relapse. So it is very important to find out such children who are prone to develop frequent relapse. This retrospective study was conducted in the paediatric department of Dhaka Medical College Hospital (DMCH) from January to December 2005.Total 100 children with relapsed NS of them 50 had Frequent Relapse NS (FRNS) and 50 had Infrequent Relapse NS (IFRNS) were included in the study with a view to find out the risk factors for relapse. Data were collected from previous medical and hospital records. Data were analyzed by using SPSS program. Chi-squared test and Student's t-Test were used as statistical test and p value < 0.05 was taken as significant. NS was more common among 2-6 years of age (67%) with male to female ratio roughly 2:1. Most of patient with frequent relapse had age <5 years, came from rural area and belongs to poor social class compared to that of infrequent relapse. The mean age at first onset was significantly less in frequent relapse group than that of infrequent relapse group. Majority of atopic child belongs to frequent relapse cases. Low serum albumin level, low serum total protein level, culture positive Urinary Tract Infection (UTI) at initial attack were observed to be statistically significant in case of frequent relapse group.DOI: http://dx.doi.org/10.3329/fmcj.v7i1.10292Faridpur Med. Coll. J. 2012;7(1): 18-22

Background: The novel corona virus has been identified as the cause of respiratory illness in Wuhan, Hubei province, China, since December, 2019. It has spread almost all the countries and areas (212) in world. Due to distinct demographics of infection, variation of case fatality and clinical presentation in different countries, the knowledge of demographic distribution and analysis of clinical profile from this study would help for patient management of COVID-19 till the invention of specific drug and vaccines. We aimed to analyze the clinical profile of fist 100 cases of COVID-19 admitted in a teaching hospital. Methods: In this observational study, RT-PCR confirmed first 100 hospitalized COVID-19 cases, admitted in Mugda Medical College Hospital were included. With well informed consent, a structured questionnaire was fulfilled during the time of hospital stay. Data were analyzed with clinical outcome, hospital stay, clinical staging and comorbidity of admitted patient from 20th March to 10th April. Results: Among the total participants, male were predominate (59%). Age groups were ranging from 9 to 80 years and mean age was 43 years. Common symptoms were fever (91%), cough (33%), dyspnea (41%), sore throat (12%), diarrhea (12%) and myalgia (2%). Mild cases (53%) were common, followed by moderate (31%), severe (13%) and critical (3%). Average hospital stay was 11 days. Common comorbidities were diabetes mellitus (21%), hypertension (17%), chronic kidney disease (11%), bronchial asthma (8%), stroke (3%) and ischaemic heart disease (2%). Conclusion: Distinct demographic presentation with age variability, clinical presentation with variable fatality in different countries may help the further steps taken by the policymaker of low resource country for the prevention of infection and management of COVID-19. Birdem Med J 2020; 10, COVID Supplement: 18-22

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